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Problems we help solve:
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Are
Antidepressants Safe The FDA now recommends caution in the use of any antidepressants in children. The caution is in the form of a "Black Box" (link for text) warning. There has been some statistical increase in suicidal thinking, talking about suicide and self-injurious behavior among children using antidepressants. However, there were no suicides in the study of about 4400 children. Also the data and warning is regarding the first few months of treatment. Most psychiatrists and physicians do not think that antidepressants should not be used, but it does make more sense to use caution and monitor closely, which should have been done all along. I believe that there may be two factors involved: 1. Is talking about suicide a possible improvement in function? If a severely withdrawn teen gets an antidepressant, and then starts sharing more of their thoughts and feelings with someone, even thoughts of suicide, this might be an improvement in functioning. 2. There may be what I call "Bipolar Type Activation." This is when the antidepressants may make things worse rather than better. Such things to watch out for: 1. Increased
irritability and anger EFFECTIVENESS As of this date (October 2006) the only antidepressant that has clearly shown benefit in children is Prozac. That does not necessarily mean that others antidepressants may not help an individual child.
It is easy to identify Bipolar prone kids if one of the parents has been already diagnosed as bipolar. However, there are more often cases in which both parents may have a Bipolar flavor, but never diagnosed nor easily seen. Also a relative may have bipolar disorder, such as grandparent or great-uncle. I think such children are at greater risk of having adverse effects. One of the clearest tip-offs that a family may have an undiagnosed bipolar flavor is a family that constantly is filled with drama. Obviously, any genetic relatives who have made serious suicide attempts or have completed suicide also needs to be taken seriously. Bipolar disorder also is hidden in other disorders such as alcoholism, gambling addition, and spending sprees. About 40% of bipolar people struggle with OCD and Panic Disorders. And some research indicates that 50% of children who are diagnosed with depression before age 10 tend to eventually be diagnosed with bipolar disorder. I often use the image of a row boat in a lake in which there are lots of other faster, larger boats creating a great deal of wake. The person with bipolar flavor never feels that things feel very stable or smooth for very long. They feel constantly tossed about by outside forces. If there is a bipolar flavor or activation with antidepressants, it does not mean that antidepressants cannot be used. What it means is that a mood stabilizing medication should be started prior to taking the antidepressants. I believe that most adverse effects could be handled very well if parents and the child were informed clearly about what beneficial effects are expected, and what symptoms might well be considered "Bipolar Type Activation." John E. Swank
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© 2012 John E. Swank, MS, LPCC Swank Counseling , 21 Robin Hood Lane, Troy, OH 45373 Number of visits to pages on our website since December 26,2011 The content of this website is for public use and for information only. It is not intended to be used in any other manner. The authors disclaim any liability, loss, injury, or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this website. The information on this site is not intended to replace examination or treatment by a qualified healthcare professional and should not be used for diagnostic or treatment purposes. Correspondence from this website is not necessarily secure, and confidential information should not be shared. Disclosure and Privacy Information
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Swank Counseling
