Authors of a new comprehensive analysis of antidepressants for children and teenagers say the benefits of treatment trump the small risk of increasing some patients' chances of having suicidal thoughts and behaviors.
The risk they found is lower than the one the Food and Drug Administration identified in 2004, the year the agency warned the public about the drugs' risks in children. After the warning, U.S. youth suicides increased and some mental health experts said reluctance to try antidepressants might be to blame.
The new analysis includes data from seven studies that were not part of the previous FDA analysis, including information from two large pediatric depression trials that was unavailable three years ago.
Researchers analyzed data on 5,310 children and teenagers from 27 studies. They found that for every 100 kids treated with antidepressants, about one additional child experienced worsening suicidal feelings above what would have happened without drug treatment. In contrast, the FDA analysis found an added risk affecting about two in 100 patients.
There were no suicides in any of the studies. The antidepressants included Prozac, Paxil, Zoloft, Celexa, Lexapro, Effexor, Serzone and Remeron.
"The medications are safe and effective and should be considered as an important part of treatment," said study co-author Dr. David Brent of the University of Pittsburgh School of Medicine. "The benefits seem favorable compared to the small risk of suicidal thoughts and behavior."
The antidepressants worked best when used to treat anxiety, the analysis found. They worked moderately well treating obsessive-compulsive disorders. They worked less well but were still effective in treating depression.
The analysis, supported by grants from the National Institute of Mental Health and the Robert Wood Johnson Foundation, appears in the April 18 issue of the Journal of the American Medical Assn. For a summary of the study, go to jama.ama-assn.org/cgi/content/abstract/297/15/1683.