SSRI antidepression pills have a black box warning label yet are prescribed to half a million kids.

Question

SSRI (selective serotonin reuptake inhibitors) antidepression pills have a black box warning label for increased risk of suicide & homicide. The carton literally says this drug increases the chance of being a danger to yourself & others. Yet half a million kids a year are prescribed SSRI, a recent 17% increase. 0 evidence serotonin effects depression

Answer 1

This claim is misleading and worded badly.

SSRIs have a black box warning for increased suicide risk in young people but not for homicide. It is important to keep in mind that the black box warning issued by the FDA could not determine any conclusive causal relationship between SSRIs and increased depression/suicide risk. Depression is a trans-diagnostic condition. It's also important to recognize that all these observational studies have limitations. The claim that SSRIs make people dangerous to others is also misleading. The efficacy of antidepressant treatment, including SSRIs, is well supported by the evidence. This article has conducted a multitude of studies and provides significant evidence that SSRIs were more effective than placebo. 

 

It's difficult to make a complete claim on this issue as SSRIs have widely varying effects on individuals, especially young people. However, it's important to recognize that SSRIs do prove positive in many young individuals today, especially given the unique challenges that each new generation faces.

 

 

https://www.nejm.org/doi/full/10.1056/NEJMp1408480

https://journals.sagepub.com/doi/abs/10.1177/0269881109105498

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Answer 2

I would like to preface this response by saying that I personally certainly have some bias against the original claim as its creator was siding with RFK Jr., current nominee for United States Secretary of Health and Human Services, who has expressed other medical opinions I disagree with.

The conversation around SSRIs increasing violent tendencies in patients has been going on since the 1980's, and is very complex. Right off the bat, it is true that SSRI pills have labels that warn of increased risk of suicide, but not homicide, according to the list in this FDA article. The larger issue is whether or not this labeling is justified, and therefore whether or not the original statement is misleading through its language. Looking further into this topic, I opened the two articles posted by the same user on Bluesky underneath the original post, here and here. These articles provided some information, but the main takeaway I found is that the scientific community has not reached any type of consensus on this issue. Some research papers, like this one published in the British Medical Journal and this one published by Mary Ann Liebert, Inc., come to the conclusion that the correlation exists, supported by clinical trials. This paper, published in the Journal of Psychiatry and Neuroscience, says that the issue should be looked at from the perspective of wanting to balance anti-depressant treatment so that people are not afraid of participating in it. This National Library of Medicine study outlines a similar idea, while also highlighting that the increased risks are present mainly in adolescents.

Based on the reading I have done, there is a correlation between SSRIs and increased suicidal ideation in adolescents. However, I think it is hard to say that we should stop prescribing them because of this. We do not know how much these medications are lowering suicidal ideation, only that they are, as per this page on SSRIs by the National Health Service in the UK, which states, "It would be too simplistic to say that depression and related mental health conditions are caused by low serotonin levels, but a rise in serotonin levels can improve symptoms and make people more responsive to other types of treatment, such as CBT."

Overall, I believe that the original post is too general in its wording, and is missing important context. I would love more to see feedback on this post as I believe this is a complex issue that may not have one concrete answer.

Comments

This is a very well carried out fact check. You expanded on the claim and added a heavy amount of supporting evidence from trustworthy sources. I like how you never completely disagreed with the claim, but rather labeled it as too general and misleading.

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This fact check is executed very well. The amount of articles and sincere research provides a strong backing for your argument. I agree with you that the original source is too general in wording, and this is a complex issue without a singular answer for all.

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I really appreciate your fact-check! It has a lot of helpful info. I do have some concerns about your argument regarding RFK Jr. being unreliable because you don't agree with his views. I do think there can be sources to help with your stance but without that, it is just an opinion.
I really like all the sources you used and all the research you have done, it is very helpful! I also appreciate the context regarding the article being very generalized, it is a good reminder of what to look for when questioning articles.

Answer 3

I see the concern for this Argument and it is true that these anti depression pills do come with a black label warming that can be seen as concerning to some but upon further research the warning label does not indicate a contribution to an increase in homicides rather than a decrease in homicides. With These powerful drugs it's hard to know the outcomes that can come with these when prescribing these to millions of kids worldwide and although I think we should give these out with more precaution than what we have been doing I think it's still safe to say Powerful drugs have been helpful to many to alleviate these depression symptoms. In conslsion they have not been proven to increase the risk of suicide & homicide.

sources:

https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/suicidality-children-and-adolescents-being-treated-antidepressant-medications?utm

https://www.healthaffairs.org/doi/10.1377/hlthaff.2023.00263?utm_source

https://www.nature.com/articles/s41380-022-01661-0?utm_source

Comments

This fact check is well done. I like how you touched on the opposite side, connecting to their concerns. But then you were able to prove that this is a misleading claim using multiple reputable sources.

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I liked how you took a strong stance in this fact-check. You got to the point quickly and effectively. The sources provided in the description provide a backing to your argument as well. You should link these to specific text in your paragraph in future fact checks.

Answer 4

In 2004, the FDA's decision to require a black box warning on antidepressants for an increased risk of suicide and homicide remains controversial. Studies have shown that after the label was added, doctors began prescribing fewer antidepressants, which may have led to an increase in suicidal behaviors and attempts. Although the warning highlights the potential risk, many individuals still need antidepressants. A study published in the National Library of Medicine reviewed two case studies where patients refused antidepressants due to fear of suicide, and potentially worsening their conditions. The report argues that the warning may have unintended negative consequences, such as discouraging necessary treatment and spreading misinformation. While antidepressants can effectively treat depression and anxiety in children and teenagers, careful monitoring is essential due to potential side effects.

https://pmc.ncbi.nlm.nih.gov/articles/PMC6510161/

https://www.mayoclinic.org/diseases-conditions/teen-depression/in-depth/antidepressants/art-20047502

https://pmc.ncbi.nlm.nih.gov/articles/PMC6493906/