Leading article: Pills are not enough

It is brave of the European Agency for the Evaluation of Medicinal Products to approve the prescription of Prozac for children as young as eight

The EMEA does add some important caveats to its ruling, however. It stipulates that Prozac should only be prescribed to children who have already failed to respond to psychological treatment. It also demands careful monitoring of those patients taking the drug, particularly in the initial stages of treatment. These are reasonable safeguards, although we would add that doctors should also, ideally, monitor patients when the course of treatment ends. Studies have shown this is a period in which a risk of suicide intensifies in the users of antidepressants.

And the central decision to approve the prescription of Prozac for this age group is justified. Depression is a serious problem for an increasing number of children and adolescents - and one that it does no good for the wider society to dismiss or deny. It has been estimated one in 10 children is affected by mental illness. If this is confronted early, it will give the child a greater chance of coping with the problem in later life.

Prozac has a part to play in that process. SSRIs have helped thousands of people cope with depression across Britain. And the evidence suggests that Prozac can do so for children too. The EMEA is justified in concluding that the risks are outweighed by the benefits. Prozac was never linked as strongly as other SSRIs with adverse side effects. This does not mean, of course, that Eli Lilly, Prozac's manufacturer, can now market its product without restraint. It would be unacceptable if the company began to market Prozac at children, in the same way that it pushed the drug on depressed adults in the past in the US.

We would also caution doctors against the presumption that simply because they are authorised to administer Prozac to children, or adults for that matter, they should necessarily do so. Medical professionals should adopt a range of treatments. Counselling and therapy should be used alongside medication.

SSRIs undoubtedly have a place in the treatment of depression. But they must be employed in the framework of a national health service that attempts to treat depression properly, rather than one that simply fobs off the depressed with handfuls of pills.

Comments