Paragraph 3 reads: "The teen had been taking anti-depressant Zoloft and acne medication Roaccutane when she hanged herself in her bedroom."

Suicide no reason to halt medication
16:33 AEST Thu Oct 28 2004

Anti-depressants should be used with caution in teenagers but one suicide did not mean drug prescriptions for adolescents should be halted, a psychiatrist said.

Results of an inquest released on Thursday found that two commonly-used medications may have aggravated 15-year-old Sydney girl Vivian Crane's depression, causing her to kill herself in June 2000.

The teen had been taking anti-depressant Zoloft and acne medication Roaccutane when she hanged herself in her bedroom.

Brisbane-based child and family psychiatrist John Warlow said both medications could occasionally aggravate depression.

However, he warned that parents and doctors should not shy away from prescribing drugs on the sole basis that they might have certain side effects.

"It's obviously tragic what happened and cases like this frighten everyone," Dr Warlow told AAP.

But I have concerns that for every one of this sort of situation there's going to be another 10 or 20 kids who suicide because they weren't prescribed an anti-depressant.

"There's definite research to show that where anti-depressants are prescribed there's a decrease in the suicide rate."

Roaccutane had on rare occasions been implicated in depression and psychosis, he said.

If an adolescent patient developed depression while taking the anti-acne drug, Dr Warlow said it might be worth asking them to stop taking it for a time before considering prescribing anti-depressants.

"If I had a kid who was depressed on Roaccutane I'd have significant concerns about Roaccutane and then I'd find out more before making a decision," he said.

Anti-depressants would usually only be prescribed if other treatments such as counselling and cognitive behaviour therapy had failed, Dr Warlow said.

"If you ask most clinicians what they think about the use of anti-depressants most will say `I have used them wisely'," he said.

"Most sensible ones will say `I'm informing the parents of the pros and cons and watching out particularly for agitation and worsening suicidal thoughts'."