NewsHour Extra Feature Stories
NewsHour Extra features stories can help students identify and interpret
key issues in current events. This activity anticipates one class period,
but the follow-up essay might be assigned as homework, or in another period.
Warm Up: Use
initiating questions to introduce the topic and find out how much your
Have students read NewsHour Extra's feature story and answer the questions
on the reading comprehension handout.
Use discussion questions to encourage students to think about how the
issues outlined in the story affect their lives and express and debate
can write an 500-word editorial on the topic expressing their views and
send it to NewsHour Extra [email@example.com]
for possible publication.
Students are graded on their answers to reading comprehension questions
and/or their editorial.
Story: Most Antidepressants
Deemed Unsafe in Children, 4/26/04
1. What is depression?
Do you think depression is something that affects teens? How?
2. Have you ever felt
really sad or depressed for more than a few days at a time? What did you
3. Do you think that
all drugs given to patients should be tested on the target population?
For example, drugs prescribed for children should be tested first on children.
Drugs prescribed for women should be tested on women. Why or why not?
Questions: (click here for printout)
1. Why is the Lancet
The British study
is a "meta-analysis" -- the first comprehensive scientific
review of both published studies and unpublished data that pharmaceutical
companies have said they own and have the right to withhold. The British
government allowed the scientists access to the unpublished, largely
2. What did the Lancet
study conclude? What impacted this conclusion considerably?
The report concluded
that young patients, aged 5-18, should not take four popular antidepressants
-- Paxil, Zoloft, Effexor and Celexa -- because there was a clear risk
of suicidal behavior among those taking the drugs and no benefit. The
fifth drug studied -- Prozac -- was found to be effective for depressed
children and did not have an elevated risk of suicide.
The authors of
the study said the unpublished research had a major impact on the report's
of the published articles, the authors concluded the drug was either
effective, safe or both," said Tim Kendall, one of the authors
of the study. "When you look at the combined evidence, it is ineffective,
unsafe or both."
3. How did the drug
companies respond to the Lancet study?
The drug companies
contend that their products are safe and deny they are risking the lives
of younger patients in order to sell more prescriptions.
in children of our drug in particular, is a very, very, very small percentage
of the overall total prescriptions of this product," Mariann Caprino,
spokeswoman for Pfizer Inc., which makes Zoloft, told The Washington
Post. "To suggest that we are motivated by profiting off of children
4. What is depression
and how many children and adolescents suffer from it?
It is estimated
that between 2 percent and 6 percent of all children and adolescents
suffer from depression. Depression is a mood disorder in which sad,
lonely, irritable or weary feelings don't go away and prevent a person
from living a productive life.
5. What is one biological
sign that researchers think is associated with depression? What have they
created to help with this? How do they work?
There isn't a
medical test for depression but researchers have discovered that those
with depression often have an imbalance of neurotransmitters -- the
chemical messengers that allow brain cells to communicate with each
One class of
antidepressant drugs are known as selective serotonin reuptake inhibitors
(SSRIs). They work by increasing the levels of serotonin, a neurotransmitter,
in the brain. These increases can change a person's mood. All five antidepressants
in the Lancet study are SSRIs.
6. What are "off-label"
prescriptions and why are they important in understanding the antidepressant
Much of the controversy
surrounding antidepressants and children is that few of the drugs are
specifically created for them. Instead, physicians prescribe them for
"off-label" use. Off-label means the drugs have not been systematically
studied for safety and effectiveness for the purpose the doctors prescribe
them -- for example, to treat depression in children or adolescents
-- but can be given to patients based on clinical experience and medication
7. How have different
government agencies in different countries reacted to the antidepressant
In England studies
like the one in Lancet and the growing concern of a link between the
antidepressants and suicide caused the British government to recommend
against most depressants, except Prozac, for children.
On Thursday European
Union regulators recommended that Paxil not be given to children and
In the United
States, the FDA has been more cautious. In March the agency requested
that drug manufacturers strengthen their warnings about the possible
links between the drug use by adolescents and suicidal thoughts and
The agency also
asked an expert committee at Columbia University to review drug-company
data and to create a definition of what is suicidal thinking and suicidal
behavior. The report, due this summer, could influence any final FDA
(more research might be needed):
1. If you were a parent
with a depressed teenage child would you allow your child to take antidepressants?
Under what circumstances? Why or why not?
2. Should "off-label"
prescription use be allowed? Why or why not? What are the implications
of stopping them?
3. Should drug companies
have to share all data from clinical studies about their products with
outside researchers? Why or why not? How might research sponsored by a
drug company be different from research sponsored by a government agency
like the FDA?
Write a 300-500 word
essay on any of these topics providing clear examples. Send your completed
editorial to NewsHour Extra [firstname.lastname@example.org].
Exceptional essays might be published on our Web site.