Magazine article Clinical Psychiatry News

British Raise More Questions on Use of SSRIs

Magazine article Clinical Psychiatry News

British Raise More Questions on Use of SSRIs

Article excerpt

Despite concerns raised by recent British analyses of antidepressants, parents must remain vigilant about seeking help for their children who have depressive symptoms, Dr. David Fassler says.

"The most important thing is that parents need to be advocates for their kids and make sure they get a good evaluation and accurate diagnosis before anyone starts talking about treatment," said Dr. Fassler, a child and adolescent psychiatrist based in Burlington, Vt., and a Board of Trustees member of the American Psychiatric Association.

Ongoing concerns about the safety of selective serotonin reuptake inhibitors (SSRIs) for children and about suppression of unfavorable trial results prompted Craig J. Whittington, Ph.D., of the Centre for Outcomes Research and Effectiveness at University College, London, and his colleagues to conduct a metaanalysis of published and unpublished data on the safety and efficacy of SSRIs for treating major depressive disorder in children (Lancet 363[9418]:1341-45, 2004).

In an accompanying editorial, the editors of the Lancet noted that the idea of drug therapy based on selectively reported favorable results should be unthinkable, but the inclusion of unfavorable results from unpublished data in the metaanalysis suggests such selective reporting "is what has been happening for research into the use of antidepressants in childhood" (Lancet 363[9418]:1335, 2004).

The analysis included five randomized controlled trials of SSRIs vs. placebo in children aged 5-18 years, as well as results from eight unpublished studies.

Overall, the researchers concluded that benefits did not outweigh the risks for the use of paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and venlafaxine (Effexor). Results from one published study of paroxetine by Dr. Martin B. Keller and his colleagues showed an increased risk of suicidal ideation among children who took the drug, compared with placebo (J. …

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