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medpundit |
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Thursday, September 16, 2004The 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 0 Comments: |
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