Since Someone Asked, Why I Am Against Lexapro For Teens

I wasn't planning on this being Lexapro theme day, but over the weekend I got the following comment in response to a post of mine on Lexapro's FDA approval for teens. The commenter authors the It's Me With OCD blog.

"I am curious to know the reason for the author's hostility towards giving Lexapro to adolescents? I apologize, I am new to your blog, so maybe the answer is here and I just haven't read enough yet."

Here are my primary reasons for being against--"hostility" is sort of overstating the case--Lexapro use in teens and kids (and, yes, even adults).

Suicide/suicidality: As established by the FDA's black box warning and a recent WHO study, both of which found quite a bit of suicide and suicidality connected with anti-depressants, especially in kids and teens. The evidence in adults is more mixed.

Withdrawal problems: while Lexapro isn't as rough in this regard as Paxil and Effexor, the reality is that it's not an easy drug to get off of and I don't particularly fancy giving brain zaps to teens. I went through them myself. Not fun.

Efficacy issues: Forest Labs hasn't published the efficacy data of Lexapro for major depression in teens, so it's impossible to know how well the drug allegedly works. Generally, when pharma companies aren't publishing efficacy data, they are hiding something.

Suspect FDA approval: see my post from earlier today.

Because anti-depressants represent America's quick fix culture: compare our approach with the UK's, where anti-depressants are mostly banned for anyone under 18 and where its own health care agencies (ie, NICE) recommend approaching depression treatment by going through watchful waiting, making sure patients are eating properly and exercising, psychotherapy and, then and only then, moving to anti-depressants. Since making that shift a few years ago in the nation's depression treatment policies, I've heard no reports of British teens going through a suicide epidemic. In fact, the suicide rate went down over there when most anti-depressants (except Prozac) were banned for under-18s.

We should be taking a similar approach in this country with depression.

Thanks for asking.