Colorado study offers hope for addicted teens

Bill Scanlon, Rocky Mountain News

Published November 8, 2007 at midnight

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Depressed teens who also abuse drugs can be treated safely with antidepressants and therapy to help them better cope with their addictions, a team of Colorado researchers has found.

The study of 126 Colorado teens is good news to clinicians, who haven't been able to help depressed, addicted teens because they haven't known whether antidepressants are safe for them.

Teens who feel sad or angry all of the time often become their own druggists, turning to marijuana, amphetamines or alcohol.

Although such teens number more than a million, they rarely receive the help they need.

They are barred from clinical trials until they sober up, something difficult enough for any addict, much more so for a teen also struggling with mental problems.

Dr. Paula Riggs and her colleagues at the University of Colorado School of Medicine tracked 126 Colorado teens who have exhibited bad behavior, major depression and a history of abusing at least one drug.

Riggs found that when you give such teens fluoxetines, such as Prozac, and combine it with therapy aimed at changing their addictive behavior and giving them coping skills, about three-fourths of them see big drops in their depression after four months. The study appears in Archives of Pediatrics & Adolescent Medicine.

Which comes first, the depression or the addiction? It's about 50-50, Riggs said. Researchers know that mental illness is three or four times higher in teens with substance- abuse issues.

Riggs' study showed that antidepressants and therapy not only brightened the teens' mood, but also helped them kick their addictions.

Studies in 2003 and 2004 linked antidepressants with an increase in teen suicide. Subsequent research has debunked some of that, but not all of it.

Teens using antidepressants are 52 percent more likely to commit suicide, according to a Columbia University study. But since it's the depressed teens who receive antidepressants, it is just as likely that the mental state, not the drugs, led to the suicide attempt, many scientists say.

The same authors found that between 1990 and 2000, the areas of the nation that had the biggest rise in antidepressants for teens also had the biggest drop in teen suicides.

Riggs' study found that depression largely disappeared in 76 percent of the teens who got both the medication and the behavior-cognitive therapy. Also, 67 percent of those who received only therapy, not medication, saw their depression lift. In both groups, if the depression lifted, substance abuse dropped.

"These kids come to drug treatment with only one tool in their tool bags," Riggs said. "If their dog dies? 'I think I'll get high.' If their girlfriend breaks up with them? 'I think I'll get high.' "

Therapists help them cope with cravings, make decisions and solve problems.

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