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psc brown bag iconFDA and ABCs: Unintended Consequences of Antidepressant Warnings on Academic Achievement

Ellen Meara (The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College), Ezra Golberstein, Susan Busch

11/08/2010, at noon in room 6050 ISR-Thompson.

In 2003 and 2004 the FDA issued a series of warnings noting a possible association between pediatric antidepressant use and suicidality. The FDA’s actions initiated an abrupt decline in pediatric antidepressant use of 20-30 percent following years of steady increase. This unique natural experiment permits the examination of several salient questions for policy and clinical practice: 1) the unintended consequences of a regulatory policy designed to protect pediatric patients from safety risks of a widely used class of pharmaceuticals; 2) the effect of untreated depression on human capital development in adolescents; and 3) a comparison of the effects of depression episodes among adolescents more and less likely to receive antidepressants, in a real world setting, on academic outcomes. Using seven years of the annual cross-sectional National Survey on Drug Use and Health (2001-2007), we implement a Regression Discontinuity design to study academic outcomes in over 100,000 adolescents aged 12-17 who were and were not likely affected by the FDA warnings. We find that in 2002 and 2003 (before the FDA warnings on antidepressants) adolescents with depression had grade point averages .11 to .26 points higher than adolescents with depression in the latter half of 2004 and 2005 (after the warnings). This trend was limited to adolescents with probable depression; grade point averages did not change during this time period among adolescents without a recent depression episode. Effects on grade point average were driven entirely by girls, but both girls and boys with probable depression reported participating in more fights after the FDA warnings.


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