By Stacey Perlman

New concerns have arisen over whether anti-depressants can lead to increased suicidal behaviors in children. The Food and Drug Administration (FDA) organized its first public hearing on Feb. 3 to investigate and re-examine 20 studies of eight anti-depressants including Paxil, Zoloft, Effexor and Celexa.

The side effects of anti-depressants, also known as selective serotonin reuptake inhibitors (SSRIs), came into question after reports in Britain emerged last summer that Paxil and Effexor may have a connection to increased suicidal tendencies when used by children, according to a Feb. 2 Boston Globe report.

The FDA issued a memo prior to the hearing defining its concerns that it may overlook a pattern of increased suicidal behavior due to anti-depressants and a false sense of security in SSRIs. Yet, by deciding too soon there is such a risk, there is a possibility medication will be used too conservatively or become entirely unavailable to patients who have a need for medication.

“We need more research,” said Carol Glod, associate professor in the school of nursing, director of nursing research at McLean Hospital in Belmont and lecturer in psychiatry at Harvard Medical School.

Glod is planning on conducting her own study on children ages 12 to 19 to look at the comparative effects of Celexa and Welbutrin to a placebo. She said she will look at whether both drugs are more effective than the placebo and whether they’re effective for treating depression.

Michael Montagne, a professor of social pharmacy at Massachusetts College of Pharmacy and Health Sciences also said more data is needed. However, he feels the advisory panel’s conclusion that the FDA should issue stronger warnings about these drugs was a good decision.

“Only about one-third of adults react to the drugs, so you can kind of see there is a general population saying it’s wonderful and then you’ll have others that don’t get a response, and in both groups there will be suicide, Montagne said. “Apply that to children and the same thing could happen.”

He said while some suicides occurred within the first week of using medication, some suicides have also occurred after discontinuing the medication.

“If parents are concerned they should contact their doctors but should not, by themselves, stop the use of a drug right away because some of the suicides occur after the drug has been stopped,” he said.

The FDA does not expect any conclusions from its public hearing to be made until this summer. With such a severe concern from parents and patients, psychiatrists face more pressure in determining what medications will work best for each patient.

“We don’t know which patients will benefit by which drug because the science to date doesn’t support predicting who’s going to respond positively or negatively to different medications,” said Virginia Tay, a clinical specialist in psychiatric nursing, a psychologist and a staff member in the Mental Health Department at Lane Health Center.

“It becomes a matter of clinical experience to determine who we think would benefit from what kind of drugs. And we do that by noting people’s symptoms,” Tay said.

While the study focuses on children, there is concern for adults – including college students.

“I think the bottom line is it’s a controversy that applies to both children and adults. We need more research, it’s not a black and white issue,” Glod said.

College students who are on anti-depressants should be aware of the possible side effects.

“I think college students should become very aware of this. The greatest increase in prescribing anti-depressants is for college students,” Montagne said.

It is important for students to find out from their doctors whether they are suffering from serious depression or if they are struggling with the stresses of life, Montagne said, in which at some point they should be discontinuing medication.

Students feel depression may be a large problem among college students.

“There’s a lot of pressure on students to succeed,” said Everette Egun, a sophomore pharmacy major.

He said more peer groups should be formed in order for students to have people they can relate to.

Others don’t see the potential severity of depression.

“I don’t see it a lot in my friends,” said Jody Forness, a freshman criminal justice major. “College is supposed to be a happy place.”

Students, however, recognize Northeastern’s sources of help for students who do feel depressed.

“If I was really depressed, I would go to our resources,” Forness said.

Tay said that while at Northeastern she has not seen a case where someone’s behavior has been related to anti-depressants.

“People come in with feelings of [suicide], I can’t think of anything that has ever made me think, ‘Gosh, I wonder if that drug was responsible for the suicidal feelings this person is having,'” Tay said.

With the severity of this issue, Tay said it generates fear in people and it’s a problem that is “important to recognize and try to grapple with.

“There have been a small number of children and adolescents who have become suicidal. In a study of 4,000 adverse effects in taking these drugs, I think it was something like 160 children had some self-injurious behavior.

“To withhold the possible benefits doesn’t seem warranted to me at this time. What does seem warranted is to look into it more carefully,” she said.