Safety data on the use of antidepressants with children

After the examA recent report in The British Medical Journal questions the efficacy and safety of several antidepressants for children. In studies involving Prozac, Effexor and Zoloft, researchers analyzed the quality of the research and the efficacy and adverse effects of the drugs. They conclude that the benefits of these medications have been exaggerated and the adverse effects have been downplayed. In addition, trials consistently found large improvements in groups of children given placebos in the place of drugs. These results show that for children, a major benefit from the newer antidepressants is unlikely while a small positive effect is possible.

Another report, published in the New England Journal of Medicine, concludes that the benefits of these medications outweigh the risks when used for the treatment of obsessive-compulsive disorder, but treatment of depression shows neither a negative or positive effect overall. Some children respond positively and others show no benefit. Adverse effects include agitation, nervousness, mania and hypomania.

Past clinical trials of newer antidepressants (Selective Serotonin Reuptake Inhibitors) have not reported any suicides. In fact, for each 1 percent increase in the use of SSRIs among adolescents, there was a decrease of 0.23 suicides per 100,000 adolescents per year. These researchers report that non-drug interventions such as cognitive-behavioral therapy appear to be beneficial for children with depression and suggest that nondrug therapies may be initially helpful in establishing the persistence of depression before considering treatment with antidepressant medication.

British Medical Journal 2004, 328(7444); pp. 879-883. New England Journal of Medicine, 2004; 350(15), pp. 1489-1491.

Published in ERN September 2004 Volume 17 Number 6

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