Robert F. Kennedy Jr. is set to chair a committee, as directed by a recent executive order of President Donald Trump, focusing on the potential overuse of antidepressants among young people. While some of these medications are approved for pediatric use, their application is more prevalent amongst adults. Hence, the inquiry of this commission could lead to changes in prescription methodologies moving forward.
The newly formed ‘Make America Healthy Again Commission’ is aimed at tackling chronic illnesses, with an emphasis on mental health disorders. Its efforts are centred around addressing America’s growing health crisis, re-prioritizing the focus of both public and private healthcare sectors towards understanding and significantly reducing chronic disease occurrences, including those amongst children.
The executive order lays down a blueprint for countering chronic disease, which includes advocating for healthier lifestyles and examining the health influences of modern technological practices. It highlights alarming statistics about the high percentage of chronic illnesses in America and underscores the nation’s lower life expectancy in comparison with other countries.
As per the order, ‘To effectively manage rising health issues in America, we need to shift our national attention towards understanding and drastically reducing chronic disease rates, and extinguishing childhood chronic illnesses. It is crucial to maintain the credibility of scientific methods, discourage undue influence on expert recommendations, and enhance transparency regarding extant data. Our healthcare system should aim for health promotion rather than just disease management.’
The commission has set itself specific goals concentrating on mental health and the administering of antidepressants. Selective serotonin reuptake inhibitors (SSRIs), a prevalent type of antidepressant, are under particular focus.
SSRIs treat symptoms of depression and other disorders like generalized anxiety. The Mayo Clinic describes their mechanism of action, explaining that serotonin is among several neurotransmitters in the brain. These neurotransmitters transmit signals between nerve cells in the brain. Under normal circumstances, serotonin is reabsorbed into these cells, a process known as reuptake. However, SSRIs obstruct this process.
The reason SSRIs are deemed ‘selective’ is due to their principal effect on serotonin and not other neurotransmitters. The U.S. Food and Drug Administration has sanctioned the use of certain SSRIs, including Citalopram (Celexa), Escitalopram (Lexapro), Fluoxetine (Prozac), Paroxetine (Paxil), and Sertraline (Zoloft), specifically for treating depression.
Antidepressants, such as SSRIs, are frequently prescribed medications aimed at managing depression and an array of other conditions like anxiety and obsessive-compulsive disorder. The National Institute of Mental Health reports that in 2021, 8.3% of adults aged 18 and above in America experienced a major depressive episode. This rate elevated to 18.6% for those aged 18-25.
A study revealed that the monthly rate of antidepressant prescriptions for youth saw a rise of 66.3% between January 2016 and December 2022. Several antidepressants act specifically on certain neurotransmitters. These include Serotonin reuptake inhibitors (SSRIs), Serotonin-noradrenaline reuptake inhibitors (SNRIs), Norepinephrine and dopamine reuptake inhibitors (NDRIs), Tricyclic and tetracyclic antidepressants (TCAs), Serotonin antagonists and reuptake inhibitors (SARIs), and Monoamine oxidase inhibitors (MAOIs).
The executive order proposes to explore the potential over-medication of children and the risks related to antidepressants. A key objective of the commission is to ‘evaluate the ubiquity of and dangers associated with the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs.’
Certain reports indicate that a few SSRIs are sanctioned for use in children as young as 6 to 10 years old, depending on their diagnosis. Despite this, the usage of these medications is significantly greater in the adult population compared to minors.