Pediatricians and Antidepressant Medications: Black Box or Black Hole?

Abstract

The intent of this commentary on the article by Leslie and colleagues1 is to describe ongoing efforts by the American Academy of Pediatrics (AAP) and other pediatric professional organizations to support pediatricians and other pediatric clinicians as they attempt to provide care for their patients who have mental health disorders. The article by Leslie et al is extremely important to primary pediatric medical providers and provides an important framework for this commentary for several reasons. The AAP recognizes the critical importance of providing pediatricians with assistance in the pharmacological management of children and adolescents with mental health disorders. The FDA Pediatric Advisory Committee’s vote in September 2004 to advise the FDA to require a “black-box warning” sounded an alarm extending from the examination rooms of tertiary child psychiatry clinics in Boston, Massachusetts, to solo primary care providers in the Oklahoma panhandle and rural Montana. Pediatricians were left wondering what to do about their patients already taking antidepressants (for a variety of conditions, … Address correspondence to Lynn Mowbray Wegner, MD, Learning and Development Associates, 3500 Gateway Centre Blvd, Suite 140, Morrisville, NC 27560. E-mail: lwegner{at}learningfirst.com