The benefits of antidepressants for children and adults seem to be greater than the risks of suicide or suicidal thoughts, a study analysis suggests.
The study, published in JAMA, collected data from 27 trials involving children under 18 with major depressive disorder (MDD), obsessive-compulsive disorder (OCD) or non-OCD anxiety disorders.
Researchers found that compared to placebo, antidepressants were effective in treating all three types of disease, although the effects were strongest for non-OCD anxiety disorders, intermediate for OCD and more modest in treating children with MDD. They also seemed more effective in adolescents than younger children.
While the findings did show the drugs increased the risk of suicidal behaviour, this was by less than 1%, about half as many as found in a previous US Food and Drug Administration analysis. In addition, the researchers noted that there were no suicides by patients in the studies.
Lead author Dr Jeffrey Bridge said these findings suggested that “treating young people with antidepressants is worth the small risk associated with them, at least in the short term”.
In 2004, the FDA directed manufacturers to put a black-box warning on all selective serotonin reuptake inhibitors describing the increased risk of suicidal behaviour in children and adolescents being treated with the medication. This resulted in reluctance by patients and families to use these medicines. Study co-author David Brent suggested the FDA now “consider labelling that calls attention to the risk but wouldn’t have the effect of frightening people away from using the medication when needed”.
The FDA said the JAMA analysis was consistent with its own findings on these products and with its recommendations and warnings to consumers.