What every psychologist should know about the Food and Drug Administration’s black box warning label for antidepressants.

In 2004, the Food and Drug Administration released a black box warning label for all antidepressants, indicating an increased risk for suicidality in children and adolescents. The label was subsequently updated in 2007 to include those up to 24 years of age. Data have since emerged to indicate changes in clinical practice patterns of nonspecialists (i.e., nonpsychiatrists) prescribing medications. Among the changes reported in practice patterns are an increased likelihood of referral and a decreased willingness to prescribe antidepressants. Findings also indicate marked reductions in ambulatory visits for depression among children and adolescents, lower rates of diagnosis of depression in this age group, a spillover effect to adults, inaccurate understanding of the actual risk communicated on the warning label (on the part of primary care practitioners), and increased suicide rates among children and adolescents. Recent findings have important implications for practicing psychologists, and specific recommendations are offered.