Review of all major studies involving anti-depressants in children

www.nami.org/Apr 18 2007

The Journal of the American Medical Association (JAMA) has published a review of all major studies involving anti-depressants in children and adolescents by a team of researchers from Western Psychiatric Institute in Pittsburgh.

The review concludes that the benefits of antidepressant medications appear to be much greater than the risks. Specifically the review concludes "Relative to placebo, antidepressants are efficacious for pediatric major depressive disorder (MDD), obsessive compulsive disorder (OCD), and non-OCD anxiety disorders, although the effects are strongest in non-OCD anxiety disorders, intermediate in OCD, and more modest in MDD. Benefits of antidepressants appear to be much greater than risks from suicide/suicide ideation attempts across indications." The impact of the medicines was different depending on the child's age and their condition. It should be noted that there were no completed suicides in any study.

The newly published review surveyed all studies between 1998 and 2006, regulatory reports from the United States and Britain, and clinical trial registries.

The researchers were interested in further understanding the risks of the medicines in relation to reported suicidal thinking and attempts, as well as the possible benefits the compounds offered for anxiety disorders, obsessive compulsive disorder, and major depressive disorder. There was no new clinical trial conducted-rather they did a meta-analysis of multiple studies already in print or unpublished but relevant with specific attention to this area of clinical import.

This review is useful to parents weighing the benefits and risks of antidepressants for a child who has active symptoms of anxiety, OCD or MDD. The latest data states that over four million children and adolescents in this country struggle with a serious mental disorder that causes significant functional impairments at home, school, and with peers. In addition to understanding the risks and benefits of medication, there are many other factors important to child and adolescent mental health care, including a comprehensive evaluation, attention to a child's strengths, school and relationships, assessment of substance use, the role of family work and psychotherapy for the child, and monitoring needs when a child is placed on antidepressants. Every child should have the benefit of a specifically tailored plan to address his or her needs.