View Full Version : Antidepressants Can Worsen Bipolar Disorder in Kids, Say Advocates

10-26-04, 05:43 PM
WASHINGTON, Oct. 22 (AScribe Newswire) -- "Depressed children should be screened for symptoms of mania and carefully evaluated for emerging bipolar disorder (formerly called manic-depressive illness) before taking antidepressants," says Martha Hellander, research policy director at the Child & Adolescent Bipolar Foundation (CABF).

Speaking at the annual conference of the American Academy of Child and Adolescent Psychiatry, Hellander hailed the recently announced FDA warnings that antidepressants are associated with an increase in suicidal behavior as a wake-up call to doctors and parents who may assume that all depressed kids have the same illness and need the same treatments. "Mood disorders in kids are a major public health crisis, and antidepressants are an essential part of treatment for some, but not all, of those kids," she said. "We desperately need more treatments for suffering children who can't take antidepressants and for whom psychotherapy is not enough." She added that children with emerging bipolar disorder or schizophrenia, both complex genetic illnesses that can emerge gradually during childhood and adolescence, often display symptoms of depression or attentional problems that are not recognized until much later as the early manifestations of these serious, lifelong illnesses.

Doctors often diagnose depression and prescribe antidepressants when those medications may not help and may even worsen mania, a syndrome that occurs in children with bipolar disorder. Hellander cited an internal survey of CABF members done in January, 2004, in which hundreds of CABF members reported that their children had first talked of wanting to kill themselves, or harmed themselves, within days or weeks of starting an antidepressant, and were later found to have bipolar disorder.

The survey also showed that hundreds of other parents attributed their child's improvement to antidepressants, usually in combination with lithium, or another medication such as an anticonvulsant or an atypical antipsychotic, the standard treatments used to treat bipolar illness in adults.

"Our kids are suffering, and too many are dying or becoming disabled from mood disorders, which are associated with a shockingly high mortality rate exceeding that of some forms of cancer. Bipolar disorder and depression in children are malignant, chronic, and life-threatening brain disorders, putting children at risk of school failure, addiction, and suicide. The FDA's action serves to alert parents and clinicians that a screening for mania and consideration of different treatments is required." The language to be added to the warnings on antidepressants includes the recommendation that doctors screen children for bipolar disorder and mania and take a family history before prescribing the drugs. Close monitoring is also recommended, but Hellander raised concerns whether most families realistically can provide a secure, suicide-proof environment with constant supervision.

CABF calls for a federal research initiative on pediatric bipolar disorder and depression, similar to those undertaken for ADHD and autism, and suggests that Congress consider mandating insurance companies to cover a two-week inpatient stay for children on antidepressants if recommended by the child's physician, to ensure adequate monitoring.

About CABF

CABF is a national nonprofit organization with 24,000 families raising children diagnosed with, or at risk for, bipolar disorder. CABF's Web site provides global access to information, support and resources to families and to professionals who serve them. CABF has a national 14 member board of directors (mostly parents of children with bipolar disorder), and a Professional Advisory Council made up of two dozen of the world's leading bipolar researchers. CABF's Research Policy Director, Martha Hellander, is a member of the National Advisory Mental Health Council.


Sissy Allen, Child & Adolescent Bipolar Foundation; 757-253-7589;