Confused whether or not antidepressant drug warnings have any impact? Well, you’re not alone. Today the New York Times shows just how confused the experts are on this issue as well, with two warring sides pretty clearly defined.

One side, the authors of the study published last week in The American Journal of Psychiatry, say their data is very suggestive of a causative link between the FDA black box warning and an increase in the suicide rate amongst young adults.

The other side points out that the study showed no such causation relationship, which in fact is true. The study published last week could not establish a causative relationship in the manner in which it was designed.

While such links may be suggestive, few policymakers or researchers would base long-term, serious policy decisions (like whether the FDA erred or not) on one year’s worth of data. Especially when that data is inconclusive and contradictory:

While suicide rates for Americans ages 19 and under rose 14 percent in 2004, the number of prescriptions for antidepressants in that group was basically unchanged and did not drop substantially, according to data from the study.

So why did the media pick up on the study and report findings that the study didn’t find?

Because the story then was: “The government overreacted to the threat, mandated a black box warning, and here’s what you get — increased suicides because less prescriptions are being written.” That’s a good story.

The reality turns out to be: “We only have one year’s worth of data (now 2, as the 2005 prelim. data has come out showing a likely slight decline in the suicide rate), we shouldn’t make broad assumptions on this data, and we shouldn’t make claims in the discussion section of our research papers that are largely unsupported by our data (e.g., establishing a causative relationship).”

With the 2005 data now available, it seems that the suggestion that any policy mandate — such as a “black box” warning on antidepressants — led to an increase in suicidal behavior was premature. Future researchers should be wary (as I would hope their scientific training taught them) to jump to conclusions. One or two years’ worth of data does not a robust trend make. Next time, let’s all hold off on the extreme predictions of disaster until more data is available.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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    Last reviewed: By John M. Grohol, Psy.D. on 20 Dec 2007
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