Commentary on medical news by a practicing physician.

  • Epocrates MedSearch Drug Lookup


    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.

    "Opinions are like sphincters, everyone has one." - Chris Rangel

    email: medpundit-at-ameritech.net

    or if that doesn't work try:


    Medpundit RSS

    Quirky Museums and Fun Stuff

    Who is medpundit?

    Tech Central Station Columns

    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews


    Medical Blogs


    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc




    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It


    SOAP Notes


    Cut-to -Cure

    Black Triangle



    Kevin, M.D

    The Lingual Nerve

    Galen's Log



    Doctor Mental



    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House



    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day


    The Business Word Inc.

    Point of Law

    In the Pipeline


    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station





    The Skeptic's Dictionary

    Recommended Reading

    The Doctor Stories by William Carlos Williams

    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn

    Intoxicated by My Illness by Anatole Broyard

    Raising the Dead by Richard Selzer

    Autobiography of a Face by Lucy Grealy

    The Man Who Mistook His Wife for a Hat by Oliver Sacks

    The Sea and Poison by Shusaku Endo

    A Midwife's Tale by Laurel Thatcher Ulrich



    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info



    Thursday, September 16, 2004

    Unintended(?) Consequences: Not surprisingly, the FDA decision to place "severe warnings" on the newer anti-depressants regarding the risk for suicide, is discouraging their use - even among doctors. Most of the doctors in the article say that they'll be hesitant to treat any depression in adolescents, and plan instead to refer them to psychiatrists.

    The problem is, there aren't enough psychiatrists to see them all in a timely fashion. The wait for a pediatric or adolescent psychiatrist in my area is two to three months. I've had kids end up in the hospital for suicidal gestures while waiting to get in with the psychiatrist. And yes, that's because I, too, am afraid to prescribe drugs for them while they're waiting for that appointment. These kids act impulsively. Unless someone's overtly suicidal, it's impossible to predict who's going to act out in the near future, and who will be just fine until the psychiatrist has time for them. But, even though the studies did not find any increase in suicide, only suicidal thoughts and behaviors, the language the FDA and the media have used in describing the warnings are so strong that it would be medicolegal suicide for a primary care doctor to prescribe them.

    Decreasing the rate of prescribing was the implicit goal of the warnings , however. The FDA even extended the warnings to all anti-depressants so physicians won't be tempted to use any of them:

    The advisory committee decided that the suicide warning should also be placed on the physician prescribing sheets for an older set of antidepressants called tricyclics. These medicines have largely fallen out of favor because of the damage they can do to patients' hearts and the risks that result from overdoses.

    The warning was extended to them in part because of the "great risk in scaring clinicians back to the tricyclics," said Dr. Thomas Laughren, a top agency official.

    Until we have drugs with zero risks and zero side effects, looks like depressed teenagers are just going to have to suck it up.

    posted by Sydney on 9/16/2004 10:15:00 PM 0 comments


    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page


    Home   |   Archives

    Copyright 2006