My Out-of-Control Teen: On compact disc

Thank you Mark, it worked this time and I ordered the CD's. It will be a lot easier to listen in my car without my twin 15 year old girls nearby while I drive to work. I am sure I will be back in touch with questions after listening. I am grateful to have found your website and I hope to find some help in single parenting these girls. One is easy, one seems to be the challenge of my life.

Take care,

D.A.

Teen Suicide On The Rise

Mark-

I saw on the news last night that teen suicide is on the rise. Do you know whether or not this is really the case, and if so, why?

T.T.

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Hi T.,

Two reports released this week show significant increases in youth suicide rates between 2003 and 2004, following a consistent drop since the 1990s. A study released in the September issue of The American Journal of Psychiatry, shows a 14 percent increase in suicide rates for children and adolescents under the age of 19 from 2003 to 2004. The second study, published in the Centers For Disease Control and Prevention's Morbidity and Mortality Weekly Report, shows an eight percent increase in suicide rates for individuals between the ages of 10 and 24 in 2004, following a 28 percent decrease over the last 15 years. This is the largest escalation in this group since the agency began collecting suicide data in 1979.

Unfortunately, child and adolescent suicide is at the highest rate in 15 years.

According to the Centers for Disease Control and Prevention's report, the decline took place from 1990 to 2003 (from 9.48 to 6.78 per 100,000 people), and the increase took place from 2003 to 2004, (from 6.78 to 7.32).

Whether this is a short-term spike or the start of a trend, we, as parents, must do everything in our power to prevent more teen suicides from occurring.

The U.S. Food and Drug Administration placed a black box warning on antidepressants for pediatric use in 2004, which was followed by pervasive media coverage and a 22 percent decrease in the prescription of antidepressant medications from 2003 to children and adolescents. The American Academy of Child and Adolescent Psychiatry advised the FDA's Pediatric Advisory Committee against placing a black box warning on antidepressant medications.

More research is needed to find out whether there is a correlation between the black box warning and this increase in teen suicide. My concern is that the FDA's warning has made families fearful of obtaining help. This is a tragedy as treatment works.

Antidepressant medications, when monitored and paired with talk therapy like cognitive behavioral therapy can be an effective component of treating youth depression. The National Institute of Mental Health's (NIMH) Treatment of Adolescents with Depression Study (TADS) reports that a combination of Fluoxetine (Prozac®) and cognitive behavior (talk) therapy led to significant clinical improvement in 71 percent of moderately-to-severely depressed adolescents.

For more information on antidepressant medications, visit www.parentsmedguide.com or www.physiciansmedguide.com.

Online Parent Support

Vitamin B12 Injections for Autism

Mark,

Have you heard anything about vitamin B12 shots for autism? And if so, do you know about it's effectiveness?

C.W.

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Hi C.,

Unfortunately, preliminary results of a small ongoing study of vitamin B12 injections for children with autism showed no signs of significant benefit, but researchers remain hopeful.

Hope is derived from anecdotal reports of remarkable clinical improvements using subcutaneous vitamin B12 (methyl cobalamin), although there have been no supporting published studies. Vitamin B12 is an antioxidant involved in metabolism pathways for cellular methylation, which has been implicated in other neurological disorders like schizophrenia and Alzheimer's Disease.

The researchers reported that no significant benefits have turned up yet for the 14 patients who have completed three months in the current double-blind crossover study. They found no significant differences with active versus placebo treatment for the following measures:

· Clinical Global Impression Scale Improvement (P=0.4129),
· Peabody Picture Vocabulary Test scores (P=0.2895), and
· Social Communication Questionnaire verbal results (P=0.4211).

A significant improvement found for nonverbal Social Communication Questionnaire scores in the vitamin B12 group compared to placebo (P=0.0309) disappeared after adjusting for multiple testing.

The researchers randomized half of the participants to six weeks of 64.5 ug/kg of subcutaneous methyl cobalamin injections every three days and the other half to a similar schedule of saline injections disguised to maintain the double-blind. For the following six weeks, the children were crossed over to the opposite group.

Diagnosis of autism was confirmed using several clinical measures including the Vineland Adaptive Behavior Scales, Autism Diagnostic Observation Schedule, and Mullen Scales of Early Learning. Patients could stay on all other treatment modalities they entered with but no additions were allowed during the trial.

Interestingly, several of the children seemed to respond well. Three of the eight participants who subsequently completed three months of open-label therapy and two of the five who have completed six months were rated "much improved" on the Clinical Global Impression Improvement scale.

While there is a general trend toward improvement in several of the subjects, this trend does not reach group significance with this small sample size.

Autism is so heterogeneous - you can't expect one treatment is going to work for all kids with autism.

The real usefulness of the study may be to indicate which patients will respond to the treatment, which is generally thought to have few side effects.

The study does not have a traditional design and will likely be scrutinized critically. It is a wonderful bridge between research and the complimentary and alternative medicine that so many patients are using where ground needs to be broken.

The researchers said they plan to enroll at least 42 children in the study, which was supported by the University of California at Davis.

Online Parent Support