Treating long-term depression has grown into a major drug industrySeriously depressed children and their families have been on an emotional roller-coaster even more harrowing than usual this past year as scientists, corporations and a federal agency wrestled with whether commonly prescribed medications increase the risk of teen suicide.

It comes as no surprise to anyone that teenagers and some even younger children suffer episodes of depression. But only in the past decade or so has a subset of these youngsters been recognized as having major or clinical depression - a deep funk that lasts weeks or months and seriously detracts from the ability to carry on a functional life.

Nor will it come as a surprise to most people that treating long-term depression has grown into a major industry, with billions spent annually in the U.S. and abroad on medicine and talk therapy aimed at alleviating depression and its symptoms.

In the beginning, treating teens with antidepressants was viewed with some skepticism in the medical community, in part because of a feeling that many eventually outgrow the problem, and in part due to a recognition that raging hormones and rapidly developing teen brains make for a combination that can be tricky to treat.

This ambivalent situation wasn't enough to scare off pharmaceutical companies stretching for more customers or desperate parents stretching for answers. Use of antidepressants on children and teens has surged.

Beginning with little more than a rumor - with stories that some teens on drug therapy seemed to be attempting and sometimes accomplishing suicide - a potentially ghastly story has been growing in the public consciousness.

Last year, Dr. Andrew D. Mosholder, an expert at the Food and Drug Administration who assesses the safety of medicines, found that children on antidepressants were almost twice as likely to become suicidal as those given placebos in 22 earlier studies.

In what we can only hope was a cautious move to avoid undue concern, the FDA suppressed Mosholder's study and hired outside researchers to reexamine the data upon which it was based. Now comes news that this new look at children and antidepressants has arrived at very similar conclusions for two popular drugs, Paxil and Effexor.

Another drug, Prozac, continues to be recommended by Mosholder for treating childhood depression. According to the new study, it is particular ly effective when combined with a series of talk therapy sessions.

British authorities last year banned all drugs except Prozac for treating childhood depression. To date, our FDA has issued only a precautionary advisory on the subject. This, coupled with its handling of Dr. Mosholder's earlier findings, raises serious questions about the agency's objectivity and motives. Sen. Charles E. Grassley of Iowa has called for an investigation.

Congress should thoroughly examine both whether the FDA is adequately serving American kids in this specific instance, and whether drug firms are being permitted to warp the agency's handling of such matters.


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