Major Depression: Most Antidepressants Ineffective For Children, Teens

Posted on June 10, 2016

Major depression, or major depressive disorder, is estimated to affect around 2.8 percent of children aged 6-12 years and 5.6 percent of adolescents aged 12-18 years in the United States, according to the study authors.

For children and adolescents with major depression, most clinical guidelines recommend cognitive behavioral therapy (CBT) and other psychological therapies as the first-line treatment. However, an increasing number of youngsters with major depression are being prescribed antidepressants, despite the U.S. Food and Drug Administration (FDA) warning against antidepressant use for children and adolescents after studies found increased suicide risk among young users of the drugs.

For this study, the researchers set out to investigate whether the benefits of antidepressant use outweigh the risks for young people with major depression. The team conducted a systematic review and meta-analysis of all unpublished and published double-blind, randomized controlled trials up to May 2015 that assessed the treatment of major depression among children and adolescents.

In 34 of the trials - including 5,260 participants of average age 9-18 years - the researchers identified only one antidepressant, fluoxetine, for which the benefits outweighed the risks when it came to efficacy and tolerability.

The results suggest that the vast majority of antidepressants are ineffective for children and adolescents with major depression, and many of them may be unsafe.

"The balance of risks and benefits of antidepressants for the treatment of major depression does not seem to offer a clear advantage in children and teenagers, with probably only the exception of fluoxetine. We recommend that children and adolescents taking antidepressants should be monitored closely, regardless of the antidepressant chosen, particularly at the beginning of treatment."
- Study co-author Prof. Peng Xie, The First Affiliated Hospital of Chongqing Medical University, China

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Category(s):Child and/or Adolescent Issues, Depression

Source material from Medical News Today