“Historically in U.S. schools, such subjective screening has shown an 84% ‘false positive’ rate that could lead to teens being prescribed antidepressants, which in turn, have been linked to an increase in suicide and/or acts of violence.”

The mental health industry watchdog, CCHR, reports on two new studies—one that debunks the efficacy of depression screening on teens and one that shows an antidepressant treatment as ineffective and unsafe.   

By CCHR International
The Mental Health Industry Watchdog
July 15, 2022

A new study in Preventive Medicine has concluded that depression screening of adolescents does not reduce their treatment for suicidal behaviors.[1] The theory has been that such screening would result in early detection and, thus, decrease emergency department visits, hospitalizations and treatment. However, Citizens Commission on Human Rights International, a mental health industry watchdog, says historically in U.S. schools, such subjective screening has shown an 84% “false positive” rate that could lead to teens being prescribed antidepressants, which in turn, have been linked to an increase in suicide and/or acts of violence.[2]

In June, the International Journal of Risk Safety Medicine also published a study by experts, professors Peter C Gøtzsche and David Healy, raising concerns about the first U.S. approved SSRI antidepressant, fluoxetine. They reviewed several core studies upon which the drug was approved and determined: “Our reanalysis of the two pivotal trials showed that fluoxetine is unsafe and ineffective.”[3]

Fluoxetine is the only SSRI antidepressant that is Food and Drug Administration (FDA) approved for use in treating major depression in pediatric patients. Yet, the FDA warns that that children treated with antidepressants for any indication should be closely observed for clinical worsening, as well as agitation, irritability, suicidality, and unusual changes in behavior.[4]

CCHR obtained IQVia statistics for 2020 that show 2.1 million American children are taking antidepressants, of which 1.6 million are in the 13-17 age group.[5] A 2021 study of high school students in Pennsylvania showed that those given universal screening versus the usual process of targeted student referral were nearly six times higher in being identified for major depression and more than twice as likely to start treatment.[6]

This translates to a high potentiality for antidepressants or other psychotropic drugs to be prescribed, especially if the findings of this study are also replicated in other states. A United Nations Human Rights Commissioner’s report on mental health published in February 2022 warned of an overreliance on mental health drugs, which are a “significant obstacle to the realization of the right to health.” The focus of mental health systems and services should be widened beyond the biomedical model to include a holistic approach that considers all aspects of a person’s life, the report urged.[7]

Since 1999, CCHR has called for mandatory toxicology tests to be conducted on perpetrators of acts of senseless violence to isolate any pattern that links psychotropic (mind-altering) drugs to violence. This was because in the Columbine High School shootings that year, the coroner originally reported that in testing Eric Harris, the ringleader, no drugs were found. CCHR pressured for a re-test for SSRI antidepressants, which often are not specified as part of the basic drugs in toxicology testing. The re-test found the presence in Harris’ blood of an SSRI antidepressant which in clinical trials 4% had experienced manic reactions, compared to none taking a placebo. Mania is described as a “form of psychosis characterized by exalted feelings, delusions of grandeur…and overproduction of ideas.”[8]

Robert E. Crimo, III, the 21-year-old perpetrator in the Highland Park, Illinois July 4th shooting, reportedly wanted to overdose in or around 2015, according to an unnamed friend. A year later, he attempted suicide and self-harmed, reported the mother of two of his former friends. In April 2019, Crimo attempted suicide using a machete, which was handled by “mental health professionals.” Within five months, he told police he had been depressed and had a history of drug abuse.[9] It would be important to know what drugs he had been prescribed by the professionals in 2019 and any others he may have been subsequently prescribed.

Gøtzsche and Healy reviewed two studies upon which fluoxetine was approved to treat depression in children and adolescents, querying the outcomes and pointing to “unexplained numerical inconsistencies,” they said. Importantly, “suicidal events were missing in the publications and the study reports. Precursors to suicidality or violence occurred more often on fluoxetine than on placebo,” they found.

Their study is an eye-opener on potential information withheld from the FDA and, therefore, in the long run, consumers. The authors detailed:

• Fluoxetine was approved for depression in children and adolescents in the U.S. in 2002 “based on two placebo-controlled clinical trials, even though a statistical review for the Food and Drug Administration had noted there was not a statistically significant benefit for the drug on the primary outcome in either trial.” Neither of the peer-reviewed publications described the suicidal events that were mentioned in reports and other evidences the manufacturer submitted to the FDA for approval of the drug.
• “In 2004, the FDA issued a black box warning that all antidepressants may increase the risk of suicidal thinking and behavior in children and adolescents. An increase in suicidal events is also seen in adults.”
• “A meta-analysis of placebo-controlled trials in healthy adult volunteers using precursor events defined by the FDA found that SSRIs and SNRIs double the risk of harms related to suicidality and violence….”
• “About half of the suicides are missing in published trials of psychiatric drugs, and suicidal events are often called something else, e.g. emotional lability, hospital admission or depression.”
• “The approval of fluoxetine for depression in children and adolescents and the publication of many articles since, often ghost written, claiming efficacy for a number of SSRIs swept away the idea of relying on psychotherapy and other forms of support. The usage of antidepressants in adolescents, particularly females, is increasing markedly in most countries and these drugs appear to be among the most commonly used drugs by females in their later teenage years. The figures for usage increase in part because half of the patients find it difficult to withdraw from them.”

“FDA’s willingness to license claims that fluoxetine was an antidepressant in pediatric populations was a key step in the evolution of this public health problem, along with the great divide between what the academic literature on these drugs said before 2004 and what the data say when accessed. We need to understand how this situation arose if we are to prevent comparable predicaments in future.”

The fact that subjective depression surveys are also used to prove antidepressant efficacy should also be of concern, CCHR says. Since 2003, there has been a nationwide push for universal depression and mental health screening of schoolchildren. In 2016, the US Preventive Services Task Force further recommended that adolescents aged 12–18 years be screened for major depressive disorder.[10]

This becomes a diagnostic tool and schoolchildren can end up dosed with prescriptions for violence and suicide, CCHR says.

References:

[1] Kira E. Riehm, et al., “Emergency health services use and medically-treated suicidal behaviors following depression screening among adolescents: A longitudinal cohort study,” Preventive Medicine, Vol 161, Aug. 2022, https://www.sciencedirect.com/science/article/abs/pii/S0091743522001979; Marcus A. Banks, “Depression Screens Do Not Reduce Suicidal Acts in Teens: Study,” Medscape, 8 July 2022, https://www.medscape.com/viewarticle/976839

[2] https://www.cchrint.org/2020/09/22/cchr-warns-that-6-7-million-children-on-psychotropic-drugs-could-escalate/; http://edlibertywatch.org/wp-content/uploads/2014/11/Rutherford-Report-Final-Redacted.pdf

[3] Peter C Gøtzsche, David Healy, “Restoring the two pivotal fluoxetine trials in children and adolescents with depression,” International Journal of Risk Safety Medicine, 29 June 2022, https://pubmed.ncbi.nlm.nih.gov/35786661/

[4] https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/suicidality-children-and-adolescents-being-treated-antidepressant-medications

[5] https://www.cchrint.org/2016/11/30/cchr-launches-parents-know-your-rights-campaign/; https://www.cchrint.org/psychiatric-drugs/children-on-psychiatric-drugs/

[6] “Screening in High Schools to Identify, Evaluate, and Lower Depression Among Adolescents: A Randomized Clinical Trial,” JAMA Network, 5 Nov. 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571659/

[7] Annual report of the United Nations High Commissioner for Human Rights and reports of the Office of the High Commissioner and the Secretary-General, 49th session, 28 February–1 April 2022; Report of the United Nations High Commissioner for Human Rights, Mental health and human rights, 31 Jan. 2017 (A/HRC/34/32)

[8] https://www.cchrint.org/2022/05/30/as-nation-reels-from-mass-violence-cchr-calls-for-mandatory-toxicology-tests/ citing: Mark Abadi, James Pasley, Taylor Ardrey, “The 30 deadliest mass shootings in US history include Buffalo and Uvalde,” Yahoo! News, 26 May 2022, https://news.yahoo.com/30-deadliest-mass-shootings-us-184057639.html; https://www.deseret.com/2001/10/22/19612913/columbine-suit-targets-maker-of-drug-luvox; https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/021519lbl.pdf; Arianna Huffington, “Antidepressants—As Dangerous as Guns?” The New York Post, May 8, 1999

[9] Kate Briquelet and Pilar Melendez, “Parade Shooting Suspect Bobby Crimo Attempted Suicide Multiple Times, Family Friend Reveals,” The Daily Beast, 8 July 2022, https://www.thedailybeast.com/parade-suspect-robert-crimo-iii-attempted-suicide-multiple-times-family-friend-reveals; Frank Main and Elvia Malagón, “Highland Park parade mass murder suspect Robert E. Crimo III through people who knew him, police reports,” Chicago Sun Times, 9 July 2022,  https://chicago.suntimes.com/2022/7/9/23201114/highland-park-parade-mass-shooting-robert-crimo-ethan-absler-denise-pesina-jeremy-cahnmann

[10] Op. cit., Medscape, 8 July 2022