Tucson Treating children and teens suffering from depression with antidepressants may be both ineffective and potentially dangerous, a new analysis suggests.
Of the 14 antidepressants studied, only fluoxetine (Prozac) was more effective in treating depression than an inactive placebo in children and teens, the review found.
And Effexor (venlafaxine) was linked to a higher risk of suicidal thoughts and attempts compared to a placebo and five other antidepressants, the researchers reported.
"In the clinical care of young people with major depressive disorder, clinical guidelines recommend psychotherapy -- especially cognitive behavioral therapy or interpersonal therapy -- as the first-line treatment," said study author Dr. Andrea Cipriani. He is an associate professor in the department of psychiatry at the University of Oxford, in England.[...]
This study shows what has been known -- that these "medicines look less effective and riskier in children and adolescents than they do in adults," said Dr. Peter Kramer. He is a clinical professor emeritus of psychiatry and human behavior at Brown University, in Providence, R.I.
"Among them, Prozac has always stood out as relatively more effective," Kramer said.[...]
For the study, Cipriani and his colleagues reviewed 34 studies that included more than 5,200 children and teens. This kind of study, called a meta-analysis, tries to find common ground among numerous trials. Its limitations are that the conclusions rely on how well the studies that are included were done.
Moreover, most of the trials (65 percent) were financed by drug companies. And 90 percent had a risk of being biased in favor of the medication, Cipriani said.
The investigators found that only with Prozac did the benefits outweigh the risks in terms of relieving symptoms with few side effects.[...]
The review was published online June 8 in The Lancet.
"This study gives us real concern about the usefulness of antidepressants," said the author of an accompanying journal editorial, Dr. Jon Jureidini.
With a meta-analysis, the benefits of antidepressants may be overstated and the harms understated, said Jureidini. He is a research leader at the Robinson Research Institute of the University of Adelaide in Australia. [...]