How we’ve hooked a generation of children on depression pills they don’t need
As disturbing research shows a surge in prescriptions to under 18s – and one million in just three years . . .
AFEW weeks ago, my teen-age children returned home a week early from their summer holiday with their father displaying all the symptoms of post-traumatic stress disorder (PTSD).
My 17-year-old daughter Lily is usually outgoing, cheerful and unflappable. Now she jumps every time a door slams, has panic attacks and is often tearful.
Her brother Oscar, 16, has trouble sleeping and tells me he feels spaced out all the time; he’s also gripped with fear at Tube stations when he feels the shudder of an approaching train.
The reason for this transformation is that they were caught in the middle of a major earthquake in Lombok, Indonesia, in early August. They’d been on the beach on one of the tiny Gili islands when the earth-quake struck, sending buildings around them falling down. Stranded among the injured and the dead, they waited to hear if there was going to be a tsunami.
Five days and many aftershocks later, they managed to catch a flight back to London. And now we are dealing with the emotional aftermath.
If their symptoms persist, a visit to their GP would almost certainly lead to a prescription for an antidepressant.
More children than ever are on these drugs — according to recent figures obtained by BBC’s File On 4, the number of antidepressants prescribed to under-18s has risen significantly over the past three years — by 15per cent in England, 10per cent in Scotland and 6 per cent in Northern Ireland. In total, nearly a million prescriptions were issued to children between April 2015 and March 2018.
The steepest rise was in the youngest patients — those aged 12 and younger, where the number of prescriptions rose on average by 24per cent. My own research has revealed that children as young as one are prescribed the drugs.
EXPERTS have linked the rise to long waiting times for specialist mental health services. But there is also a growing social acceptance that these drugs are appropriate for children. Lily and Oscar tell me that many of their friends at their London schools are on anti-depressants for problems including eating disorders, social anxiety (wasn’t that once called shyness?) and depression.
There is a belief among children and their parents that the pills are correcting a chemical imbalance, and are therefore as necessary as a diabetic taking insulin. It worries me deeply.
In our family, antidepressants are off-limits — not because we’re opposed to medication on a point of principle, but because, when it comes to antidepressants, it’s very likely my children have inherited my inability to tolerate these pills.
While many people say antidepressants such as selective serotonin reuptake inhibitors (SSRIs) work for them, for between 1 and 4 per cent of the population, they can be lethal. I know this from personal experience.
In 2012, while suffering insomnia during my divorce, I went to a private psychiatrist and was pre-scribed the SSRI escitalopram.
As I’ve described previously in the Mail, after just two days, I became dangerously psychotic; hallucinat-ing, attacking myself with a knife and believing I had killed my children. Doctors didn’t realise my psychosis was caused by a reaction to escitalopram and put me on more pills. The results were catastrophic. Over a year, I ended up on seven different pills, and became nearly catatonic, requiring a 24-hour carer, and losing my children, my home and my job.
It was only through luck that I got better — I ended up in a different hospital where I was taken off all the drugs. Within weeks, I was back at work as a documentary film director and training for a half marathon.
I began researching the subject and discovered a hidden epidemic of people who have severe and life- threatening reactions to these pills. The side-effects themselves are no secret — they’re listed on the patient information leaflet in the packet: hostility, aggression, hallucinations and psychosis.
This is particularly worrying for those under 25. In the U.S., all SSRIs carry a black box warning — the most serious type of warning in prescription drug labelling — about the increased risk of suicidal thinking and behaviour in children, adolescents and young adults.
This was introduced after the U.S. Food and Drug Administration asked drug companies for data from all their studies, which showed that antidepressants nearly double the risk of suicide in this group.
You would have thought that this would make doctors hesitate before prescribing them to youngsters. Yet the figures suggest otherwise.
The explanation is the woeful lack of mental health services for younger people. As the NSPCC has said: ‘Tens of thousands of children in England are being rejected for mental health treatment, or spend-ing up to five months on waiting lists. It’s not good enough.’
Tracey Key, 50, a teaching assistant from Bexleyheath in London, has personal experience of the hidden dangers of prescrib-ing antidepressants to children.
Her son, Reece, was 17 when he disappeared in November 2015, seven days after taking the SSRI sertraline for the first time.
She had no idea he’d recently visited his doctor complaining of low mood: ‘Reece was in the prime of his life, he knew what he wanted to do and was very passionate about it,’ she says.
‘He was starting his second year of A-levels and had applied to university to study media and history. His friends described him as a caring, funny friend who always took the time to help others.’
She knew that things had been tricky for him that year. ‘He was concerned about his exam results,’ she says. ‘He also had a car accident and girlfriend issues. He wasn’t feeling quite right and went to his doctor without my knowledge.’
The GP initially suggested Reece see a school nurse, which he didn’t pursue. On his second visit four months later, the doctor prescribed 50mg of sertraline — but didn’t inform his parents.
‘NICE guidelines state that chil-
dren under 18 starting antidepressants should be monitored by their parent,’ says Tracey. ‘how was that possible when i wasn’t informed?’
A week later, Reece disappeared and when Tracey answered the door to policemen two hours later, she was told that Reece had killed himself in Danson Park nearby.
Tracey is convinced that Reece’s death was caused by a reaction to the sertraline.
‘Looking at Reece’s phone records, i discovered that he didn’t sleep for three consecutive nights,’ she says.
‘Since then i’ve found that this can be a sign that the body is in acute drug toxicity.
‘Looking back there were other signs, too. he missed school after a lifetime of 100per cent attendance; had to leave a history class because he found it too noisy — even though there were only eight pupils; and a teacher said he seemed vacant when she spoke to him.’
Tracey believes Reece was experiencing drug-induced akathisia — an intolerable condition of restlessness and terror. Up to a fifth of those taking antidepressants develop it, according to estimates. Clinical trial data suggests one in five of those with akathisia think about killing themselves.
‘i believe Reece would still be with us if the doctor hadn’t prescribed sertraline when all he needed was counselling to get through everyday teenage problems,’ says Tracey.
Professor Sami Timimi, a consultant child psychiatrist at the Lincolnshire Partnership NHS Trust, says he prescribes antidepressants with a heavy heart and will do so only when patients or their parents insist.
‘i explain that the drugs double the risk of suicidal intention in adolescents and that data shows they are no more helpful than a placebo,’ he says. ‘The other issue that patients are not aware of is how hard it is to come off these drugs.’
he adds that ‘there is no evidence’ these drugs correct any chemical imbalance in the brain.
PROFESSOR Timimi takes a ‘strength-based approach’ to treatment. he explains: ‘Teenagers need to be guided towards actions that will help them with their problems — it could be examining their belief systems, taking exercise, looking at how much support they are getting.’
David healy, a professor of psychiatry at Bangor University and a leading critic of SSRIS, believes these drugs are responsible not just for suicides, but also episodes of violence, with around one in 100 patients affected.
Nineteen-year-old student Ben was prescribed the SSRI citalopram by a GP after he broke up with his girlfriend.
When he went home, his parents thought they were seeing the symptoms of depression rather than those of an adverse drug reaction.
As his mother told me: ‘he had intense nightmares, couldn’t sleep and became a different person. he would sit in the corner crying or just pace up and down. A psychiatrist later told us this was akathisia, a symptom of drug toxicity.’
A few months later, Ben (not his real name) did something completely out of character. he went out with a crowbar and attacked a stranger, beating him many times, even after he had fallen to the floor.
When Ben woke up in a police cell, he had no recollection of what he had done. The court recognised that the drug had made him violent and, because the medical evidence was so compelling, he received a lesser charge of unlawfully causing the injuries and was given a suspended sentence.
he came off the antidepressants and, to his family’s relief, is now fully recovered.
Professor healy believes we don’t get the full picture of SSRI-induced violence and suicide because most of the research has been cherry-picked to exaggerate the benefits, with only the drug companies having access to the trial data (they’re not legally obliged to reveal their results, even to government regulators).
Furthermore, the drugs are tested for around eight weeks by the drug companies themselves. Most people take these pills for at least six months, and in some cases for many years.
While cases of SSRI-induced violence and suicide are relatively rare, other side-effects are not. According to published data, up to 70 per cent of patients experience sexual dysfunction ranging from genital anaesthesia to an inability to achieve erections, which can be worrying in youngsters — especially if they don’t realise it’s their medication that’s actually to blame.
Professor Timimi recalls one such case, a 17-year-old boy with impotence who suffered ‘a great sense of shame’ as a result.
‘Antidepressants are not a quick or easy fix, especially for young people where the data shows little benefit over harm,’ says Andrea Cipriani, an associate professor of psychiatry at the University of Oxford. ‘We don’t know how they affect the developing brain.’
Studies in juvenile rats have shown that giving them SSRIS early on creates changes in brain circuitry and maladaptive behaviours that persist into adulthood — these include increased anxiety-like behaviour, a reduced ability to avoid harmful situations, reduced sexual function, and sleep problems.
These changes don’t seem to happen in adult rats given the same drugs. it is unclear whether similar changes might occur in the developing brains of children.
however, Professor Cipriani argues that ‘untreated depression can be fatal’ and we shouldn’t demonise antidepressants because some young people benefit from them.
Depression is a ‘leading cause of suicide in young people, adds Dr Bernadka Dubicka, chair of the child and adolescent faculty at the Royal College of Psychiatrists. ‘Studies of young people who have tragically taken their own lives have found that very few have been taking antidepressants.
‘Antidepressants should not be used in mild depression, but in severe depression, they are an important option and can be life-saving. NICE advises that antidepressants should always be prescribed with some form of psychological support.’
Professor Timimi is concerned that by handing out pills, we are not getting to the root of the problem. ‘By offering medication, we are embedding the idea in teenagers that there is something wrong with them, whereas, in fact, they are usually reacting normally to difficult events in their lives.
‘Depression is not an illness, it’s a state of mind. The problem with medicalised therapy is that it’s one size fits all. human beings are more complex.’
THE Pill That Steals Lives by Katinka Blackford Newman (John Blake £8.99). thepillthatsteals.com