Monday, September 21, 2009
Interesting Piece in Slate This Week
Some of us in practice live through the "black box" era describe in Arthur Allen's recent piece in Slate , when we realized that, while SSRIs were a lot easier on our patients that the tricylic antidepressants of an earlier era, they were not without side effects. His point, that the rate of prescription dropped dramatically, was certainly the case in our office. In Massachusetts, of course, we had the benefit of the MCPAP program to help us through that time, and perhaps we we able to find a middle road a bit faster than most. The article, however, asks the more interesting question. Aside from the posturing, and the ideological issue of whether or not it is acceptable to pharmacologically manipulate our children, was the public health affected by this "black box" intervention? A quick look at the data says "I don't know". Adolescent suicide is uncommon enough that we can't tell through the noise whether or not this made a difference. So where does that leave us in practice? As always, doing the best we can, with the information that we have at hand.