Antidepressants safe and effective in children and teens

 

A new study shows that antidepressants are safe for children and teenagers, after all. The Food and Drug Administration, or FDA, recently warned that antidepressants increase suicide risk among teens, but this study of about five-thousand children and teens shows that antidepressants are safe and effective1. Dr. David Brent, a psychiatrist at the University of Pittsburgh medical school, the study’s lead author, and his colleagues in a meta-analysis of randomized controlled trials (RCTs), compared the number of kids that benefited from antidepressant use to those that became suicidal on these medications.

The result of the study published in the April 18, 2007 edition of the Journal of the American Medical Association (JAMA) shows according to Dr Brent that “Less than one child in a hundred experienced an increased risk due to suicidal ideation and behavior, and there were very few actual suicide attempts and no suicide completions”. He added, “I think it’s important for the FDA to continue to monitor the safety of these medications, but on the basis of our study I think the black box warning should at least be reconsidered.”

The study shows that antidepressants most benefited kids who had anxiety disorders and helped those with obsessive-compulsive disorders (OCD), and to a lesser degree but still significantly, those with major depressive disorder. As Dr Brent also noted, “The effects were more modest for depression but the benefits were still much better than if you had done nothing… because there’s also a risk of doing nothing because depression is a potentially fatal illness if untreated.”

Commenting on the study, Dr Pamela Murray, a pediatrician at the Children's Hospital of Pittsburgh, who specializes in adolescent medicine said that she is not surprised about antidepressants being most effective in kids with anxiety disorders. “My clinical experience has been that patients who go on antidepressants for anxiety disorders frequently report not only that they’re better but that their symptoms begin to abate quite quickly after they start medicines,” she noted.

Dr Murray also noted, “We also see lots of young people who have symptoms of depression, chronic headaches, chronic stomachaches, fatigue, sort of problems that could benefit from antidepressant use.” Despite that, the study shows that the benefits of antidepressants in kids far outweigh the risks and that the medications are safe and effective she emphasized, as also did the lead author, Dr Brent, the need to monitor them carefully, as indeed, we should with all medications, to be certain that they are working how they should.

Reference:

1. Bridge JA, Iyengar S, Salary CB, Barbe RP, Birmaher B, Pincus HA, Ren L, Brent DA. Clinical Response and Risk for Reported Suicidal Ideation and Suicide Attempts in Pediatric Antidepressant Treatment: A Meta-analysis of Randomized Controlled Trials. JAMA. 2007; 297: 1683-1696