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Antidepressants safe for children and adolescents

OCD and anxiety in children and adolescents under the age of 19. Fifteen trials were of major depressive disorder and included a total of 3,430 participants; six trials were of OCD, with 718 participants; and six trials were of anxiety, with 1,162 participants. The drugs used were the selective serotonin reuptake inhibitors (SSRIs) nefazodone, venlafaxine and mirtazapine; all of the studies were randomized and placebo-controlled.

Researchers found that one in 100 participants in the studies included in the meta-analysis had new-onset suicidal ideation, or suicidal thoughts, while on medication. Even fewer acted on these thoughts, and there were no completed suicides.

The results showed that antidepressants were most effective in treating anxiety, moderately effective for OCD and modestly effective for depression. The number needed to treat (NNT) a statistical term meaning the number of patients a clinician would need to treat to prevent an adverse outcome in one was 10 for major depressive disorder, six for OCD and four for anxiety. The number needed to harm (NNH) the number of patients who would need to be treated for one to be harmed was 112 for major depressive disorder, 200 for OCD and 143 for anxiety. These numbers indicate that the increased risk, while not unimportant, is not enough to outweigh the benefits of taking the medications.

"While I support the FDAs role in monitoring the safety of medications, in this case, the FDA should reconsider the black box warning on these medications," said Dr. Brent. "Our study supports the cautious and well-monitored use of antidepressant medications as a first-line treatment for anxiety, OCD and depression."


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Contact: Jocelyn Uhl Duffy
UhlJH@upmc.edu
412-647-3555
University of Pittsburgh Schools of the Health Sciences
17-Apr-2007


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