SSRIs and Suicidal Thoughts in Children

[Anonymous]

I know this has been a subject of some concern. I will not be following this thread and replying. I just don't have time to spend a lot here on Fornits. I'm just posting it as an FYI for people who already follow the issue.

Note that it costs a serious chunk of change (well, serious to me) to subscribe to the journal that published this research, so I have been unable to review the actual study.

Maybe someday I'll get a subscription, but meanwhile I have to get my ass off Fornits and write more books. :-)

Julie

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More on Antidepressants in Children and Adolescents: Analysis of Benefits and Risks

Treatment benefits outweigh the risk for suicide ideation.

Antidepressant use in children and adolescents has been associated with a twofold increase in risk for suicidal behavior. To further assess both efficacy and risk for suicidal thoughts and behaviors in the pediatric population, researchers conducted a meta-analysis of data from 27 randomized, placebo-controlled clinical trials of antidepressant treatment (mostly selective serotonin reuptake inhibitors [SSRIs]) for major depressive disorder (MDD, 15 trials), obsessive-compulsive disorder (OCD, 6 trials), and other anxiety disorders (6 trials) in pediatric patients.

The pooled differences in response for antidepressant groups compared with placebo groups were 11% for treatment of pediatric MDD, 20% for OCD, and 37% for other anxiety disorders. The differences in risks for suicidal behavior were 1.0%, 0.5%, and 0.7%, respectively. Overall, the authors calculated that a clinician would have to treat 143 patients to see suicidal behavior in a single patient. No completed suicides were reported.

Comment: This meta-analysis is the largest to date to examine efficacy and risk of antidepressant use in children and adolescents. Its importance for pediatricians is twofold: First, pediatricians may be surprised at the modest improvement in patients with depression and OCD. This finding serves as a reminder that cognitive behavioral therapy should be a part of treatment with or without medication and that SSRI medications are most effective in patients with non-OCD anxiety disorders. Second, in contrast with previous meta-analyses, this study assessed risks associated with the three disorders separately; these results point out that the risk association is with suicidal thoughts and behaviors, not completed suicides. Pediatricians can feel confident in prescribing SSRI medications for children and adolescents with specific men tal health disorders as long as side effects are monitored appropriately (in particular, agitation and increasing sadness and isolation during the first month after starting or increasing the medication).

— Martin T. Stein, MD

Published in Journal Watch Pediatrics and Adolescent Medicine May 2, 2007

Citation(s):

Bridge JA et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: A meta-analysis of randomized controlled trials. JAMA 2007 Apr 18; 297:1683-96.

[exhausted]

And this is news??

We've had people killing each other after taking certain medication here, suicides, becoming real dangers to themselves and others .. I think the one that was the worst was Eflexor or something like that

[Anonymous]

The problem is, no one knows if those kids were more suicidal without the anti-depressants or with them.

If you are depressed and you believe these drugs help, that's great. If you think they don't help or they make things worse, then don't take them. Nobody should be taking medication against their will.

[Antigen]

The problem is, no one knows if those kids were more suicidal without the anti-depressants or with them.

If you are depressed and you believe these drugs help, that's great. If you think they don't help or they make things worse, then don't take them. Nobody should be taking medication against their will.

That gets really sticky when you're talking about children. Should anybody be forced to eat salad against their will? Ideally, no. But it's a fine line I walk all too often between good wholesome encouragement of good eating habits and really sort of being a bitch about it.