Benefits of SSRIs in young people outweigh the risk of suicide, suggests US taskforce
Benefits of using SSRIs to treat young people with depression outweigh the risks of suicidal thinking or suicide attempts, according to the authors of a US report.
A taskforce was set up by the American College of Neuropsychopharmacology
(ACNP) to review available data on this issue following concerns raised
by the UK and US regulatory authorities last year (PJ, 14 June 2003,
p813, 13 September 2003, p314, and 13 December 2003, p803).
In its preliminary report, the ACNP taskforce concludes that selective
serotonin reuptake inhibitors do not increase the risk of suicidal behaviour
and that this class of drug remains an effective option for treating
children with depression. However, the authors concede that their findings
and recommendations are preliminary because they did not have access
to all unpublished data held by the manufacturers of SSRIs and by the
regulatory authorities.
“The evidence linking SSRIs to suicide is weak,” said John
Mann, co-chairman of the ACNP taskforce and professor of psychiatry at
Columbia
University College, New York. “There are strong lines of evidence
in youth — from clinical trials, epidemiology and autopsy studies — that
led the ACNP taskforce to conclude that SSRIs do not cause suicide with
depression.”
The authors reviewed 15 clinical trials on the efficacy of SSRIs and
other newer antidepressants in treating young people. Although the degree
of efficacy varied across the trials, the authors of the report conclude
that there is sufficient evidence to suggest SSRIs are more effective
than placebo in treating depression in children and
adolescents.
They also cite epidemiological and autopsy studies as evidence to support
the continued use of SSRIs. “The decline in youth suicide rates
coincides, to a striking extent, with significant increases in the prescription
of antidepressants to adolescents, mostly SSRIs,” the report states.
The autopsy studies, say the authors, suggest that suicide is more likely
when depressed individuals do not take their medicine, rather than when
they take it.
The preliminary report is available via the ACNP website (PDF 120K).
The full ACNP report will be published later this year. |
The
Pharmaceutical Journal