Most child antidepressants are ineffective and can lead to suicidal thoughts, experts warn

Only one drug out of 14 studied demonstrated benefits that outweighed the risks of children taking them

Rachael Pells
Wednesday 08 June 2016 23:59 BST

The majority of antidepressants are ineffective and may be unsafe, for children and teenager with major depression, experts have warned.

In what is the most comprehensive comparison of 14 commonly prescribed antidepressant drugs to date, researchers found that only one brand was more effective at relieving symptoms of depression than a placebo.

Another popular drug, venlafaxine, was shown increase the risk users engaging in suicidal thoughts and attempts at suicide.

The study, published in The Lancet medical journal, warns that antidepressants do not appear to offer a clear advantage in treating children and teenagers – and could change doctors’ approach towards prescribing treatments.

“Major depressive disorder is quite prevalent in children and teenagers,” said University of Oxford researcher Dr Andrea Cipriani, who led the report.

“Not only are these cases extremely underdiagnosed and under-treated, but the condition tends to present itself in a different way in children.”

“Depressive symptoms in children and adolescents are rather undifferentiated; you’ll notice more irritability, aggressive behaviour and problems in school – so the consequences of depressive episodes of children can be dramatic, increasing risk of suicidal ideas and attempts.”

Using data from all published and unpublished randomised trials of the most commonly prescribed drugs, Dr Cipriani’s team compared the effects of 14 antidepressants in young people with major depression. The drugs were ranked by efficiency, tolerability, acceptability and associated serious harm such as suicidal thoughts and attempts.

Analysis of 43 trials involving almost 5,300 participants showed that the benefits of taking antidepressant drugs outweighed the risks only in the case of one drug, fluoxetine.

“We recommend that children and adolescents taking antidepressants should be monitored closely, regardless of the antidepressant chosen, particularly at the beginning of treatment,” said Professor Peng Xie, who co-authored the report.

Major depressive disorder is common in children and adolescents, affecting around 3 per cent of children aged 6 to 12 years and about 6 per cent of teenagers aged 13 to 18.

Psychological treatments are recommended as the first-line treatment for depression in many clinical guidelines, however the use of antidepressants has slowly increased since 2005.

The number of children and teenagers taking the drugs in the UK increased from 0.7 per cent in 2005 to 1.1 per cent in 2012, with fluoxetine being the most commonly prescribed drug.

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