Paragraph 10 reads: "Readers of this column have shared compelling stories with us. One reported: '`A 50-year-old old friend of mine asked his doctor for something to put him in better spirits over the Christmas holidays, since he had just broken up with his girlfriend. He started Zoloft and awoke in the middle of the night with a strong urge to kill himself. He overcame the urge and never took another Zoloft. Had he actually killed himself, it would have been written off as due to depression, though he and I are convinced it was the pills'.''

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DO ANTIDEPRESSANTS PROVOKE SUICIDE IN KIDS?

Long Beach Press-Telegram (CA) - December 29, 2003
Author: Joe and Teresa Graedon

IN 1988 AN ophthalmologist contacted us because his daughter had unexpectedly committed suicide while taking Prozac. He was convinced that this antidepressant had somehow triggered her sudden violent act.

We could find nothing in the medical literature to support his suspicion, and so we dismissed his report as the desperate rationalization of a grieving parent. We assumed that a depressed young woman might take her life, even on an antidepressant.

Some months later an article appeared in the American Journal of Psychiatry suggesting the link might be real. Harvard psychiatrists reported that six patients had developed a preoccupation with suicide within a few weeks of starting Prozac.

We later learned that the ophthalmologist's daughter had not been depressed. Her doctor had prescribed Prozac off-label for an eating disorder. Why she hanged herself remains a mystery.

For years the Food and Drug Administration has debated whether Prozac and related antidepressants could trigger suicide or other violent acts. For the most part, the agency has dismissed such concerns as rare or unrelated to the medications.

Labeling for Prozac states, ``The possibility of a suicide attempt is inherent in major depressive disorder and may persist until significant remission occurs.''

Despite such reassurance, British regulators have just taken the unusual step of warning doctors against prescribing many antidepressants for people under 18 years old. The authorities there concluded that antidepressants such as Celexa, Effexor, Lexapro , Paxil and Zoloft could trigger agitation, suicidal thoughts and self-injury. Prozac has not been included in this advisory.

The restriction of so many popular drugs for teenagers and children has taken many American psychiatrists by surprise. The debate in England about the benefit-risk balance is likely to trigger a similar controversy in the United States.

The FDA is now being forced to re-evaluate its position on the use of such SSRI antidepressants. And some physicians are beginning to ask whether some adults might also be at risk while taking such medications.

Readers of this column have shared compelling stories with us. One reported: ``A 50-year-old old friend of mine asked his doctor for something to put him in better spirits over the Christmas holidays, since he had just broken up with his girlfriend. He started Zoloft and awoke in the middle of the night with a strong urge to kill himself. He overcame the urge and never took another Zoloft. Had he actually killed himself, it would have been written off as due to depression, though he and I are convinced it was the pills.''

While millions of people have benefited from such drugs, some cannot tolerate the side effects. Whether such antidepressants actually trigger suicidal thoughts in adults has not yet been determined. But British regulators clearly believe they pose a problem for children.

We have written about these issues in our Guides to Antidepressant Pros and Cons and Psychological Side Effects. Anyone who would like copies, please send $2 in check or money order with a long (No. 10), stamped (60 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. MX-23, P.O. Box 52027, Durham NC 27717-2027.

Q: I have been taking Pravachol to lower my cholesterol for a year. Yesterday for the first time my refill came with a warning to avoid grapefruit.

I have received a large box of Texas grapefruit and would like to enjoy it. How can I do that safely?

A: We are puzzled. According to the research, Pravachol is a drug that should not be affected by grapefruit. We think you could enjoy your grapefruit safely, but double-check with your pharmacist and physician to make sure.

Q: I am a 51-year-old female who has been plagued with persistent eczema. The skin on my hands was always red, itchy, cracked and often bleeding. My hands were always covered with bandages or gauze.

Dermatologists prescribed cortisone creams of increasing strength. None was helpful in the long term. Hand cream for dry skin was totally useless.

Five years ago I went to an allergist for an unrelated problem. When he saw my hands, he was concerned that the open sores put me at risk of infection. He suggested taking borage oil, since it had helped many of his patients.

I tried it, taking one capsule of borage oil after breakfast and one before bed. Within a few months the eczema on my hands had disappeared completely, and the condition is now only a minor annoyance. My dry skin is controlled with ordinary hand cream. I hope this tip will help others.

A: Borage oil is rich in a fatty acid called GLA (gamma-linolenic acid). The oil comes from the plant Borago officinalis, also known as star flower. We are delighted that you got such relief, but not everyone will benefit.

A placebo-controlled study recently published in the British Medical Journal (Dec. 13, 2003) suggests that borage oil is ineffective for eczema. The researchers conclude that ''it seems unlikely that dietary supplementation with gamma-linolenic acid is beneficial in management of atopic dermatitis.``

Q: You recently wrote about canker sores (aphthous ulcers). I have found that toothpaste with SLS (sodium laurel sulfate) makes the ulcers much worse! When I switched to Weleda toothpaste, I saw an immediate improvement. Toothpaste with tartar control seems to be especially irritating.

A: Thanks for the testimonial. Some dentists recommend avoiding toothpaste with SLS to reduce canker sores.

We also heard from another reader that a vitamin might be helpful: ``My mother had many canker sores. In a routine physical, she was tested for vitamin B-12 and found to be deficient. Once her doctor started her on B-12 shots, the canker sores disappeared and have not recurred.''

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York NY 10019, or e-mail them at pharmacy@mindspring.com or via their Web site: www.peoplespharmacy.org.
Edition: AM
Section: U
Page: U7
Column: People's Pharmacy
Record Number: 0401120115
Copyright (c) 2003 Press-Telegram
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DO ANTIDEPRESSANTS PROVOKE SUICIDE IN KIDS?