The FDA's decisions are not supposed to be based on anecdotes, which are emotionally compelling but scientifically unreliable. Instead, the agency prides itself on demanding evidence from controlled, randomized, double-blind clinical trials. Such studies provide no evidence of an association between antidepressants and suicide in adults and only weak evidence of such a connection in children and teenagers.
The FDA is in the process of scrutinizing the data from the studies involving minors. None of the subjects actually committed suicide, and much of the uncertainty arises from the difficulty of classifying behavior as "possibly suicide-related" and deciding whether a particular action qualifies as a "suicide attempt."
The inconsistency of the findings creates further doubt. One study of Prozac, for instance, found that subjects taking the drug were more likely to attempt suicide than subjects given a placebo, while two others found just the opposite.
In any case, since the studies cited by the anti-antidepressant crowd involved minors diagnosed with "major depressive disorder," it's odd that the FDA's advisory covers all uses and all ages. Both the breadth of the advisory and its admittedly meager empirical basis suggest that preventing suicide is not the only motivation at work.
The New York Times reported that the advisory "grew at least partly from a concern that the drugs were being handed out too freely." It quoted a psychiatrist who predicted that as a result of the advisory doctors "will start limiting their use of (antidepressants) just to patients who are clearly depressed with clinically significant symptoms as opposed to those who have very mild symptoms."
This distinction does not really follow from a concern about suicide. Severely depressed patients are especially likely to kill themselves, meaning that not only the benefits but also the risks (if any) of taking antidepressants are higher for them. Conversely, mildly depressed people may enjoy less dramatic benefits, but any suicide risk also would be lower. It seems the controversy over antidepressants and suicide has become a cover for other, unarticulated concerns about the appropriate use of chemicals to tweak one's mood and personality.
Read Townhall.com's just-published review of Jacob Sullum's book "For Your Own Good."