More warnings on use of antidepressants in children

Certain antidepressants can cause severe side effects and should
not be used in children, researchers have claimed.

A review of randomised controlled trials carried out on fluoxetine,
paroxetine, sertraline and venlafaxine revealed that the newer
types of antidepressants were unlikely to have any major
benefit.

But the researchers revealed biased reporting of the trial
results, with the benefits exaggerated and adverse effects played
down. The literature review, published by the BMJ, highlights their
concern that “overconfident recommendations” in
treatment guidelines could mislead doctors, patients and their
families.

The study explains how randomised controlled trials usually
underestimate drugs’ serious adverse effects, and suggests
that the fact that those caused by newer antidepressants are common
enough to be detected “raises serious concerns about their
potential for harm”.

It states: “The magnitude of benefit is unlikely to be
sufficient to justify risking those harms, so confidently
recommending these drugs as a treatment option, let alone as first
line treatment, would be inappropriate”.

It adds that pharmaceutical companies funded at least three of
the four major trials.

Selective serotonin reuptake inhibitors and venlafaxine have
been used increasingly as first line treatment for depression in
children, the report states. However, last year the Committee on
Safety of Medicines banned the use of all SSRIs except fluoxetine
in under-18s.

http://bmj.bmjjournals.com/cgi/content/full/bmj;328/7444/879