Most antidepressants prescribed to children and teenagers with major depressive disroder are ineffective and in some cases unsafe, according to a new study published in the journal The Lancet.
The study is touted as the most comprehensive analysis to date of commonly prescribed antidepressants used in children and teens. The research, conducted by scientists with the University of Oxford in the UK, involved a systematic review and analysis of all published and unpublished randomized clinical trials comparing the effects of 14 antidepressants in young people with major depressive disorder. In total, 34 trials involving 5,260 patients were analyzed.
The drugs were assessed on efficacy, tolerability (measured by how many patients stopped taking them due to side effects), acceptability (discontinuation of the medication due to any cause), and associated serious harms such as suicidal thoughts and attempts.
Researchers found that fluoxetine, known commercially as Prozac and Sarafem, was the only antidepressant whose benefits outweighed the risks. Imipramine, sold as Tofranil; venlafaxine, sold as Effexor, and duloxetine, sold as Cymbalta, were the lowest rated for tolerability. Effexor was also linked to an increased risk of suicidal thoughts or attempts.
Depression is not uncommon among children and teenagers. The U.S. National Institutes of Health estimates 2.8 million adolescents aged 12 to 17 have experienced at least one major depressive episode in their lifetime. Treating them with prescription medication has been a sticky issue since use of antidepressants became more common.
Some studies have suggested that children and young adults are more susceptible to side effects from antidepressants, in particular to suicidal ideations and attempts. In 2004, the Food and Drug Administration (FDA) required manufacturers of all antidepressants to add black box warnings on their labels that children and adolescents younger than 25 who use the medication are at an increased risk of suicidal thinking and behavior.
“Depression in youth is a serious public health problem associated with the leading cause of death in this age group, suicide,” Dr. Victor Fornari, director of the division of child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y., told CBS News. “Understanding what the evidence demonstrates is critical to guide treatment for this vulnerable population.”
Source: CBS News