Jeffrey A. Schaler, Ph.D.

Media Transcripts

Fox Morning News, WTTG Channel 5
Washington, D.C.
April 11, 1997
"On Giving Prozac to Children"

Host: Lark McCarthy, Fox News
Guests: Lise Van Susteren, M.D., Washington. D.C.,
Jeffrey A. Schaler, Ph.D., Silver Spring, Md.

8:12am (live)

MCCARTHY: The makers of anti-depressants may soon be taking aim at a whole new market - your children. Right now, the Food and Drug Administration has not approved anti- depressants, such as Prozac and Zoloft, for those under the age of 18. But drug companies are compiling data on whether these types of drugs are safe for children. Are drug companies responding to an urgent need, or, are we in danger of relying on medication for kids instead of healthy relationships? Joining us this morning is Dr. Lise Van Susteren, a psychiatrist, and Dr. Jeffrey Schaler, he's a psychologist, and a faculty member at Johns Hopkins and American universities. Thank you both for coming in.

VAN SUSTEREN: Thank you.

SCHALER: Thank you.

MCCARTHY: Dr. Schaler let's begin with you, because you've got some concerns about this, that it may be heading in a wrong direction, even to be looking at, you know, opening up this market. Why?

SCHALER: Well, my concern is that the problem we call "depression" really has to do more with the communication gap between parents and children and not the synaptic gap between neurons. I think that parents and authorities who are important to children have more to do with the unhappiness we label as depression than anything that's chemical in the person's brain. And my concern is that when we give Prozac to children, we help them to feel less badly in a bad situation, and perhaps perpetuate problems that need to be addressed psychologically.

MCCARTHY: Dr. Van Susteren, do you want to respond to that?

VAN SUSTEREN: Well yes, I certainly agree. I think that there is, there are often problems between children and their parents, and there is this communication gap, I don't think there's any doubt about that. I think, however, that there is a small, subset of children who are depressed, who are depressed because they do have problems with their brain chemistry, and they can profit from medication in a very controlled setting. It's not given loosely. We don't want to give people pills instead of talking to them.

MCCARTHY: Yes, let's talk briefly about what's happening now, that psychiatrists in their discretion, right, can prescribe these for children, but they are now looking at what proper dosage and doing major trials.

VAN SUSTEREN: Well, there is a problem because children are different from adults. Obviously we have the same bodies, but their bodies are growing. The uncertainty is what's going to happen when you give a pill to a child who has a growing body.

MCCARTHY: Would you say they shouldn't be used at all for children? How far do you go with it?

SCHALER: I think they should never be used, and we should always pay attention to what parents are doing with their children. The example set is the lesson learned. I believe firmly that parents cause the unhappiness that children experience as depression. They do it two ways: One, parents criticize children too much. And two, they set an example of low self-esteem and depression that children model. Now, those are the key issues which are often very difficult to address, but are avoided if we give Prozac.

MCCARTHY: How widely accepted is it that some depressions are biologically-based and can be helped by medication?

VAN SUSTEREN: Well, it's very widely accepted among the majority of my colleagues. There, I think, is also acceptance among my colleagues, that there are some children who have biologic depressions just as some children have diabetes. Mostly it's adults who have diabetes. Mostly it's adults who have biologic depression. But that doesn't mean that there aren't children who have [that] also.

SCHALER: The problem with that is it sounds good but there's no scientific evidence that shows these individuals, in fact, suffer with low serotonin levels. Depression is not listed in standard textbooks on pathology. It's still a theory that serotonin is related. Yes, Prozac helps people to feel less badly, but Prozac also helps people to feel less in general. It blunts emotion.

MCCARTHY: And that concerns you.

SCHALER: Oh yes.

MCCARTHY: One doctor from NIH was quoted as saying, in talking about this very issue, that "pills don't create skills," in other words, pills are no substitute for building self-esteem and social skills in children. Is that one of the things...

VAN SUSTEREN: ...That is absolutely true. That is a big danger, just giving a person a pill and thinking that all of a sudden everything is going to be perfect. It's not. But I still think that there are some children who without some form of medication can't get where they want to go. So all of the talking in the world, which is very helpful, isn't going to be enough for them.

MCCARTHY: ...would not be enough...

SCHALER: Well, it's peculiar, you know we're such a drug culture today. On the one hand we tell children they shouldn't use illegal drugs to change the way they feel. On the other hand, psychiatrists, parents, and other authorities tell children they should take legal drugs to change the way they feel. It's a profoundly confusing and double-message, that I think, perhaps, may create depression and confusion in kids in and of itself.

MCCARTHY: Is that a confusing message?

VAN SUSTEREN: Well, it's confusing in the sense that we all suffer from a belief that there are easy solutions. We have technology which fixes things very quickly for us. But the important thing is to have good people, intelligent people working with children if they need to be assessed for their depression and to have an on-going sort of relationship, so you can see whether or not medication is helpful.

MCCARTHY: Yes. Why don't we end it with some tips. If you have a child you are concerned about, who may be depressed, what would you recommend?

SCHALER: What I would recommend is that the parent look inside himself or herself, and see how he or she is depressed, and how he or she sets an example of depression for their children, and exercises some courage in terms of introspection and talking to their kids.

MCCARTHY: say certainly deal with it...

VAN SUSTEREN: I think that's an excellent idea, in addition to the consideration of the individual child.

MCCARTHY: All right, thank you both for coming in. I appreciate it.

SCHALER: Thank you.

VAN SUSTEREN: Thank you.

8:17am. Finish.