10 thoughts on “Kids, Antidepressants & Suicide: Could The Stats Cancel Each Other Out?

  • February 8, 2012 at 3:55 pm

    I wouldn’t trust any statistical analysis from Gibbons. This isn’t Gibbons’ first attempt to defend antidepressants in the wake of FDA findings they increase suicidal behavior in children/adolescents and are ineffective. Indeed, Gibbons published an analysis in 2004 arguing that suicides increased because of decreased prescriptions of antidepressants. The British Medical Journal described Gibbons’ analysis as “astonishing,” “misleading” and “reckless,” another scientist called it “incorrect” and “alarmist,” while one of his own co-authors was forced to admit the conclusions of the study were “not right,” it “doesn’t follow from the data, it is not true,” and it “serves just to scare people.” I look forward to seeing an objective critical review of Gibbons’ latest analysis because I certainly don’t trust his.

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    • February 8, 2012 at 4:03 pm

      Thanks, Cindy, for providing us with some context. I’d very much appreciate if you could cite/provide hyperlinks to the comments and sources you are citing so that I and other readers can go read up in some more depth. This goes for others, too. It always helps for those who want to check out things for themselves.

      Reply
  • February 8, 2012 at 4:37 pm

    Sure …

    Jon Jureidini, The Black Box Warning: Decreased Prescriptions and Increased Youth Suicide?, 164 Am. J. Psychiatry 1907 (2007).

    Tony Sheldon, Dutch Academics Criticise Suicide Claims in American Journal, 336 Brit. Med. J. 112 (2008).

    Interview with Ron Herings, Argos, VPRO/VARA, Radio 1 (December 7, 2007).

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  • February 8, 2012 at 7:16 pm

    Also, the earlier Gibbons analysis was 2007, not 2004. The citation is:

    Gibbons et al., Early evidence on the effects of regulators’suicidality warnings on SSRI prescriptions and suicide in children and adolescents. 164 Am J Psychiatry 1356-1363 (2007)

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  • February 9, 2012 at 9:02 pm

    Gibbons pretty much wrote his own destiny when he was the co-author of a study that appeared in the American Journal of Psychiatry in 2007 ( http://ajp.psychiatryonline.org/cgi/content/abstract/164/9/1356 )

    Gibbons co-authored study claimed there was a correlation between a 22% decrease in SSRI prescriptions and a 14% increase in youth suicide rates between 2003 and 2004, after warnings were issued by the FDA. However, the study was criticised by many.

    Respected child psychiatrist ,Jon Jureidini, said the Gibbons study “incorrectly analyzed the relationship between U.S. selective serotonin reuptake inhibitor (SSRI) prescription rates and suicide rates among children.”

    “As it turns out,” Dr Jureidini wrote, “preliminary figures are now available from the Centers for Disease Control (CDC), which show that fewer people under age 25 committed suicide in 2005 (when prescribing did decrease) than in 2004.”

    “In the year in which suicide rates rose sharply,” he said, “there was no significant drop in SSRI prescribing.”

    Despite his critics, Gibbons said at a 2009 Medscape Continuing Medical Education seminar, sponsored by Lexapro and Celexa maker, Forest Labs, “we have seen in 2004 and 2005, the years for which CDC [Centers for Disease Control] has available data on youth suicide rates, the largest increases in youth suicide rates in history since they initially were monitored.”

    The disclosure section for the seminar shows Gibbons had served as an expert witness for Zoloft maker, Pfizer, and Wyeth Pharmaceuticals, maker of the antidepressants, Effexor and Pristiq.

    Gibbons is a Professor of Biostatistics and Psychiatry and Director of the Center for Health Statistics at the [UIC] University of Illinois at Chicago College of Medicine, according to his bio on the Department of Psychiatry’s webpage.

    He is also a witness for GlaxoSmithKline in the current UK Paxil litigation, of all things he is their “expert statistician” witness.

    Definition of expert is – A person with a high degree of skill in or knowledge of a certain subject.

    It’s apparent that Gibbons does not fall into this definition and his stance regarding youth suicide from antidepressants from the SSRi family of drugs just echoes that of his paymasters.

    Bob Fiddaman

    Author of ‘The evidence, however, is clear…the Seroxat scandal.

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  • February 9, 2012 at 10:18 pm

    “statistics are like hostages – torture them enough and they’ll say whatever you want them to”>/i>

    As Bob Fiddman points out, Dr. Gibbons dug a hole with this opinion in 2005, and has been trying to crawl out ever since [see a book review… for references]. Dr. David Healy’s response today deconstructs this recent effort definitively. Dr. Bernard Carroll addressed the canceling out effect some time back here. Frankly, I think they’ve hammered on this point as a way of avoiding the dismal showing of the antidepressants in the efficacy studies in adolescents [eg Paxil Study 329]. They’d rather blame the FDA Warning for depriving adolescents of treatment than face the well documented truth that these drugs do little, if anything, for depressed kids…

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    • February 9, 2012 at 10:41 pm

      Thank you for the detailed – and solid – list of references. What is tough about this topic is that there are always going to be depressed kids – or formally depressed kids, like myself – who will swear up and down that antidepressants saved their lives. Actually, I won’t go so far as to do the latter in my case. But I will say antidepressants were well worth it for me – they helped me climb out of six slogging, agonizing years of mixed anxiety and depression, six years of my young life that I’ll never get back. And I will also say that I have never felt so miserable or so hopeless, even full of suicidal thoughts, as I have when suffering recently from chronic migraines, or, perhaps, when dealing with the side effects of the drugs used to treat them (who knows which is to blame). I have no doubt that Big Pharma fudges its data all over the place – believe me, I have no love lost for them. But I do think clinical accounts, especially patient accounts, are to be taken seriously. And that includes the people who, like the reader in my latest post, experienced the torture of suicidal thoughts shortly after beginning antidepressants, as well as others, like one of the young man whose story I told in depth in my upcoming book, who literally paid a pilgrimage to Pfizer to thank them for saving his life by developing Zoloft. Hardcore scientists will say that ultimately you have to go on stats and percentages, but I think qualitative patient experience counts, too.

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  • February 10, 2012 at 5:25 am

    “…there are always going to be depressed kids – or formerly depressed kids, like myself – who will swear up and down that antidepressants saved their lives.”

    “I do think clinical accounts, especially patient accounts, are to be taken seriously.”

    Exactly the point, in fact also the point of Dr. David Healy’s new book Pharmageddon. Antidepressants can cause dangerous Akasthisia in a few kids, alleviation of abject misery in a few kids, and do nothing in many kids. If you’re a patient, it’s important to have a clinician who is aware of all the possibilities and listens carefully to figure out which kid you are. Statistics such as those Dr. Gibbons produces only mean something before you take the first pill. After that, all of thepossibilities matter in an individual patient.

    “A new, important study published in the prestigious Archives of General Psychiatry found that antidepressants decrease the risk of suicidal thoughts and behavior in adults and have no effect on the risk in children. This is big news, since in 2004 the FDA slapped a black box warning on antidepressants, cautioning that they could cause suicidal tendencies in people under 18.”

    Dr. Gibbons testifies in court against the FDA Warning itself. That Warning is there to remind clinicians of what can happen. Faced with a kid with a refractory depression, a given clinician/patient pair may decide to try SSRIs – but should do so with eyes wide open – both of them.

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