The efficacy of antidepressant medication has once again been called into question, with new research finding that the prescription of drugs for depression in children and teens is ineffective at best.
There’s no question that depression is a notoriously tricky condition to both treat and study, with biological, psychological, and social sources of distress identified as contributors. Now, a new study, published in The Lancet, adds to the complexity of the issue.
Out of 14 antidepressant medications, only fluoxetine (Prozac) was found to be effective. On the flip side, venlafaxine (Effexor) was linked to an increased risk of suicidal thoughts and attempts compared with a placebo and other antidepressants.
"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,” said Professor Peng Xie, study co-author from The First Affiliated Hospital of Chongqing Medical University, in a statement. “We recommend that children and adolescents taking antidepressants should be monitored closely, regardless of the antidepressant chosen, particularly at the beginning of treatment.”
This is important as the spectrum of depression varies widely across age and population. In children aged 6 to 12 years old, roughly 3 percent are diagnosed with depression. For children aged 13 to 18 years old, this number jumps to 5 percent.
The study looked at 34 trials involving a total of 5,260 participants. Of these, 65 percent of the trials were funded by drug companies, possibly skewing the findings in a slightly more favorable light.
In an accompanying comment, Dr Jon Jureidini of the University of Adelaide questions the reliability of antidepressant data. He notes that in four paroxetine trials, 3 percent of adverse events were reported in the paroxetine group, but upon patient-level data reanalysis, that number was closer to 10.8 percent.
He adds: “The effect of misreporting is that antidepressants, possibly including fluoxetine, are likely to be more dangerous and less effective treatments than has been previously recognized."
In all, the research highlights the need for further comprehensive research into antidepressant medication.
“When considering the risk-benefit profile of antidepressants in the acute treatment of major depressive disorder, these drugs do not seem to offer a clear advantage for children and adolescents," the authors concluded. "Fluoxetine is probably the best option to consider when a pharmacological treatment is indicated.”
Image in text: Thomas Wilson Pratt Slatin/Wikimedia Commons