Are the SSRIs and atypical antidepressants safe and effective for children and adolescents?

Current Opinion in Psychiatry

Volumn 18, Issue 1, 2005, Pages 21-25

  Whittington, Craig J ^a   Kendall, Tim ^a   Pilling, Steve ^a  

^a UNIVERSITY COLLEGE LONDON   (United Kingdom)

Author keywords

Atypical antidepressants; Efficacy; Safety; SSRIs

Indexed keywords

ANTIDEPRESSANT AGENT; CITALOPRAM; ESCITALOPRAM; MIRTAZAPINE; NEFAZODONE; PAROXETINE; SEROTONIN UPTAKE INHIBITOR; SERTRALINE; VENLAFAXINE;

ACCESS TO INFORMATION; BEHAVIOR THERAPY; CHILD CARE; CLINICAL TRIAL; COGNITIVE THERAPY; COST EFFECTIVENESS ANALYSIS; DEPRESSION; DRUG CONTRAINDICATION; DRUG COST; DRUG EFFICACY; DRUG SAFETY; HUMAN; OUTCOMES RESEARCH; PRACTICE GUIDELINE; REVIEW; RISK ASSESSMENT; RISK BENEFIT ANALYSIS; SUICIDAL BEHAVIOR; UNITED KINGDOM; UNITED STATES;

EID: 14744285328     PISSN: 09517367     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (25)

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2. Herxheimer A, Mintzes B. Antidepressants and adverse effects in young patients: uncovering the evidence. Can Med Assoc J 2004; 170:487-488. An interesting article that raises some important issues regarding the postmarketing surveillance of drug safety and effectiveness.
3. Duff G. Selective serotonin reuptake inhibitors: use in children and adolescents with major depressive disorder. http://medicines.mhra.gov.uk/ ourwork/monitorsafequalmed/safetymessages/cemssr_011203.pdf. [Accessed 10 December 2003]
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7. Laughren TP. Background comments for February 2, 2004 meeting of Psychopharmacological Drugs Advisory Committee (PDAC) and Pediatric Subcommittee of the Anti-Infective Drugs Advisory Committee (Peds AC); 2004. http://www.fda.gov/ohrms/dockets/ac/04/briefing/4006B1_ 03_Background Memo 01-05-04.htm. [Accessed 2 February 2004]
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13. Duff G. Selective serotonin reuptake inhibitors: use in children and adolescents with major depressive disorder; 2003. http://ww.mca.gov.uk/ourwork/ monitorsafequalmed/safetymessages/efexor0903.pdf. [Accessed 19 September 2003]
14. Duff G. Safety of venlafaxine in children and adolescents under 18 years in the treatment of depressive illness; 2003. http://medicines.mhra.gov.uk/ ourwork/monitorsafequalmed/safetymessages/seroxat18.pdf. [Accessed 19 September 2003]
15. Iyasu S. Report of the Audit of the Columbia Suicidality Classification Methodology; 2004. http://www.fda.gov/ohrms/dockets/ac/04/briefing/2004-4065b1- 09-TAB07-Iyasu-Audit_report.htm [Accessed 30 September 2004]
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20. Haby MM, Tonge B, Littlefield L, et al. Cost-effectiveness of cognitive behavioural therapy and selective serotonin reuptake inhibitors for major depression in children and adolescents. Aust N Z J Psychiatry 2004; 38:579-591.
21. Wagner KD, Ambrosinin P, Rynn M. et al. Efficacy of sertraline in the treatment of children and adolescents with major depressive disorder: two randomized controlled trials. JAMA 2003; 290:1033-1041. This paper reports a combined analysis of two identical trials of sertraline, with the authors suggesting the drug was effective and well tolerated. However, data not reported (but published later by the MHRA) on remission were less favourable, and data on suicide attempt/ideation indicate a potential increased risk.
22. Wagner KD, Robb AS, Findling RL, et al. A randomized, placebo-controlled trial of citalopram for the treatment of major depression in children and adolescents. Am J Psychiatry 2004; 161:1079-1083. This study is one of two trials of citalopram (the other remains unpublished), with the authors suggesting that the drug reduces depressive symptoms and is well tolerated. These results should be interpreted cautiously given that the larger unpublished trial data are unfavourable both in terms of efficacy and safety.
23. Treatment for Adolescents With Depression Study Team. Fluoxetine, cognitive behavioural therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial. JAMA 2004; 292:807-820. This is the first study to examine the efficacy of an antidepressant combined with a psychological intervention to treat depression in adolescents. The results favour the combined therapy and suggest this is an important area needing further study.
24. Lenzer J. Specialists challenge claim that fluoxetine plus talk therapy works best for depressed adolescents. BMJ 2004; 329:529.
25. Kondro W, Sibbald B. Drug company experts advised staff to withhold data about SSRI use in children. Can Med Assoc J 2004; 170:783.