A US senator has called upon the defence department to reveal details of antidepressants prescribed for soldiers deployed in war zone. His concern comes in the context of rising number of suicides in the troops.
Ben Cardin, a Maryland Democrat, wants to determine if the antidepressants have anything to do with the trend.
He says in his letter to Defence Secretary Robert Gates, "On November 3, 2009, the Wall Street Journal reported that during the most recent month of October, 16 active‐duty American Soldiers killed themselves, bringing the total number of active‐duty suicides thus far in 2009 to 134. At this rate, it is expected that the total number of suicides in 2009 will eclipse last year's total of 140 - the highest yearly number of suicides in Army history, and the first time that the rate of active‐duty suicides exceeded that of the U.S. population.
"Multiple deployments, extended separations from family and loved ones, and the overwhelming stress of combat experience have each placed a unique and tremendous strain on the men and women of our all‐volunteer force. In response, Congress has helped provide relief by increasing the size of our forces to reduce the number and frequency of deployments.
"Unfortunately, Congress cannot as easily provide a remedy for the stress or mental trauma created by combat experience. To begin to do so, Congress must first examine how the Department of Defense (DoD) is addressing the dilemma of mental trauma suffered by members of our Armed Forces.
"To do so in a comprehensive manner, it must also examine the extent to which DoD is prescribing antidepressants to its service members, especially those deployed in‐theatre, and the methods it is employing to ensure that sufficient observation periods are conducted by properly trained mental health providers. In short, my concern is how DoD is managing the sheer volume and manner by which antidepressant drugs are being administered to our service men and women overseas.
"To this end, I ask that you compile and provide to my office a report identifying the estimated number and percentage of troops since June 2005 who have been prescribed antidepressant medications while serving in Iraq and Afghanistan. It is my understanding that electronic data is readily available for this purpose, and can be retrieved without compromising the privacy of patients or violating the protections of the Health Insurance Portability and Accountability Act (HIPAA).
"The men and women serving in our military deserve the utmost assurance that Congress is doing everything in its power to see that they are provided the best medical care available. As part of that commitment, we must also ensure that these same men and women, volunteering to serve our Nation, are not being exposed to what may potentially endanger them when they seek the medical and mental healthcare they need."
The Pentagon, though, has refused to comment on the issue and said Secretary Gates will respond directly back to the senator.
Back in 2004 the US FDA warned that children and adults taking antidepressants could become suicidal in the first weeks of therapy and that physicians should watch patients closely when first giving the drugs or changing dosages. The FDA is asking drug manufacturers to place explicit warnings about the drugs' side effects, including the risk of suicide, on their labels.
But experts felt that the FDA warning most unusual. "The FDA has traditionally based its decisions on convincing evidence. But there is still no convincing evidence linking antidepressants and suicide. (Congress has been pressuring the FDA to take a stand on this issue.) Whether scientifically warranted or not, the FDA's warning is a good reminder that antidepressants are not without risks," said Barbara K. Hecht and Frederick Hecht, Medical Editors of MedicineNet.com.
"In a study reported in the same year, the BMJ too said, "Concern is growing that serotonin reuptake inhibitors
(SSRIs) may precipitate suicidal behaviour, especially in children
although antidepressant prescribing in Britain has more than
doubled in the past 15 years, population suicide rates have
"If the risks of SSRI associated suicidal behaviour
seen in children were to apply to suicide in adults, the number
of "antidepressant induced" suicides would be small enough to
be masked by currently favourable suicide trends
studies are required to assess the risks and benefits to population
health of recent large scale rises in antidepressant prescribing."