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What to know before putting your child on an antidepressant
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Only 1 out of 14 commonly prescribed antidepressants is effective in children and teens, a new study says, and at least one is associated with increased risk of suicide. What parents of depressed kids need to know. - photo by Jennifer Graham
Only 1 out of 14 commonly prescribed antidepressants is effective in children and teens, and at least one is associated with an increased risk of suicide, a new study says.

The findings affect a small but growing number of U.S. families with children who have been diagnosed with depression. About 1.6 percent of American children and teens took antidepressants in 2012, the latest year when figures were available. Few may have been helped, according to CBS News, which reported on multinational research published June 8 in the medical journal The Lancet.

Researchers analyzed the outcomes of 34 clinical trials involving 5,260 children and teens. Out of 14 antidepressants they took, only one outperformed placebos. It was fluoxetine, better known to consumers as Prozac or Sarafem.

"When considering the riskbenefit profile of antidepressants in the acute treatment of major depressive disorder, these drugs do not seem to offer a clear advantage for children and adolescents," the authors concluded.

Previous studies have shown a link between antidepressants and suicidality. The British researchers found an increased risk of suicide attempts and thoughts especially among children and teens who took the drug venlafaxine, sold as Effexor.

The lead author of the study, Dr. Andrea Cipriani of the University of Oxford, told CBS News that the findings confirm the need for caution when putting children and teens on antidepressants "because we don't know the potential implications in the long term for a developing brain."

Everyone gets down once in a while, but major depressive disorder, also called clinical depression, is diagnosed when feelings of sadness, anxiety and hopelessness don't go away, and are accompanied by fatigue, sleep problems, weight changes and other physical ailments, according to the National Institutes of Health.

The symptoms of clinical depression in children and adults are identical but for one thing: Children are more likely to be irritable than sad.

About 3 percent of children under 12 and 6 percent of adolescents experience depression, and the incidence of depression among children is thought to be rising because, in part, of social-media pressures, materialism and the prevalence of divorce.

Genetics are also thought to play a role in up to half of cases. And one Boston College professor, Peter Gray, has blamed the decline of free play, which gives children a sense of control and exposes them to the outdoors, which has been shown to reduce depression, hence, the rise of ecotherapy.

Other risk factors for childhood depression include obesity, illness such as diabetes or asthma, low birth weight and being born to a teen mother.

International guidelines suggest first treating young people with depression with cognitive behavioral or interpersonal therapy, Ashley Welch of CBS News reported.

Other strategies include meditation, yoga and relaxation techniques, recommended by the Anxiety and Depression Association of America, and exercise and massage, recommended by The Cleveland Clinic.

Medication should be a last resort, and if then, it should be fluoxetine, the one antidepressant in the study to show value, child psychiatrist Dr. Jon Jureidini told Karen Weintraub of STAT.

No one should be on any other antidepressant, and I think its doubtful that people should be on Prozac, as well," said Jureidini of the Robinson Research Institute at the University of Adelaide in Australia.
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From the book 'Outliers' comes proof that good health is more than just genetics
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Friends Jim Young, left, Mike Natale, Jeff Natale and Ryan Kiernan were on Greenwich High School football team together and Jim and Mike were captains. Jim, who was the youngest in Sherry Young's family, was welcome in the homes of the other three boys who still had siblings around and grandparents near. - photo by Sherry Young
As I look back on my life and the lives of others, both personally and in the reading I have done, I am convinced of the necessity of positive human contact in our lives. We are doubly blessed when we are able to make good friends or are a part of a family where we are accepted and loved.

Malcolm Gladwell in his book Outliers tells of a time in the 1950s when Dr. Stewart Wolf met a physician who practiced in the area of Roseto, Pennsylvania. Roseto was settled by a group of Italian families from Roseto, Italy, who re-created their life again in America.

This was in the 1950s before drugs and measures to prevent heart disease became important. In their conversation the physician said, You know, Ive been practicing for 17 years. I get patients from all over, and I rarely find anyone from Roseto under the age of 65 with heart disease.

Wolf was surprised by these words as, It was impossible to be a doctor, common sense said, and not see heart disease.

Wolf enlisted the aid of a sociologist and friend John Bruhn to help him. They found, There was no suicide, no alcoholism, no drug addiction, and very little crime. They didnt have anyone on welfare. Then we looked at peptic ulcers. They didnt have any of those either. These people were dying of old age. Thats it.

They checked into diet, genetics and possibilities of something in the foothills of eastern Pennsylvania but nothing made sense.

What they found was that Rosetans visited one another, stopping to chat in Italian on the street, say, or cooking for one another in their backyards. (Researchers) learned about the extended family clans that underlay the towns social structure. They saw how many homes had three generations living under one roof and how much respect grandparents commanded. They went to Mass at Our Lady of Mount Carmel and saw the unifying and calming effect of the church. They counted 22 separate civic organizations in a town of just under 2,000 people. They picked up on the particular egalitarian ethos of the community, which discouraged the wealthy from flaunting their success and helped the unsuccessful obscure their failures.

What they found eventually convinced the medical establishment to look beyond the individual and understand the culture people are part of their friends, families and town they came from. They determined that the people we surround ourselves with and the values of the world we inhabit have a profound effect on who we are.

Likely, this study could have been done with other ethnicities. However, my family's experiences with the Italian families in Connecticut ring true to the study. Our hungry and growing sons, especially our youngest son, Jim, who was left home alone with two beady-eyed parents, all had some memorable experiences being fed and loved in the Cos Cob multigenerational families. Proof of the African proverb, It takes a village to raise a child.

We live in an age when the contact we have with people often is on the internet, and many of us live among strangers. Unless we make the effort to reach out, we will become isolated, especially as we age. The Rosetan study is proof that reaching out and communicating may be good for our health.
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