The vast majority of antidepressants used in treating kids and teens with depression are significantly ineffective, a new study revealed. Study authors conclude that most antidepressants do not seem to offer a clear benefit for patients.
Relieving Depression Symptoms
Antidepressants are often used to treat diagnosed cases of major depressive disorder, which affects approximately 3 percent of children and 6 percent of teenagers.
In the new study, researchers examined 14 antidepressants given to kids and teens in different randomized trials conducted through May 2015.
More specifically, the study looked into 34 trials that involved 5,260 young participants who were aged 9 to 18. The list of antidepressants included the following:
1. citalopram (Celexa)
2. clomipramine (Anafranil)
3. desipramine (Norpramin)
4. fluoxetine (Prozac)
5. amitriptyline (Elavil)
6. duloxetine (Cymbalta)
7. escitalopram (Cipralex or Lexapro)
8. imipramine (Tofranil)
9. mirtazapine (Remeron)
10. nefazodone (Serzone, Dutonin, Nefadar)
11. nortriptyline (Pamelor)
12. paroxetine (Paxil or Seroxat)
13. sertraline (Zoloft)
14. venlafaxine (Effexor)
In the United Kingdom, the most widely prescribed antidepressant was fluoxetine or Prozac. It was also the only drug found to be most effective at relieving symptoms of depression.
On the other side of the world, the most commonly prescribed drug was sertraline or Zoloft. However, researchers discovered that Zoloft was not the most effective in treating depression symptoms in the United States.
The report found that drugs such as imipramine and duloxetine have higher chances of being discontinued by patients who said they cannot tolerate the drugs' side effects.
Although study authors did not disclose what the side effects were, the U.S. Food and Drug Administration (FDA) listed down a few, which included anxiety or weight gain, depending on the drug.
Link To Suicide
The study also found that taking venlafaxine or Effexor appeared to increase risks of engaging in suicidal thoughts compared with a placebo and other antidepressants.
The elevated risk of suicide has already been recognized before. In 2004, the FDA placed several antidepressants under a black box warning for patients under 24 years old after finding evidence that suggested a suicide link.
Earlier this year, a study found a link between certain antidepressants and higher risk for aggression, as well as increased engagement in suicidal thoughts and suicide attempts among young people.
Details of the new study are published in the journal The Lancet.
Limitations Of The Study
The new study is not without limitations. Researchers warned that the gathered data likely underestimated adverse events such as suicide.
Additionally, many of the randomized trials they used for evaluating antidepressants were funded by drug companies. This could result in selective reporting of findings and poorly designed trials.
Dr. Jon Jureidini of the University of Adelaide wrote an accompanying comment for the study, questioning whether more suicidal events would have been reported if data had been more reliable.
For example, Jureidini says that in the trials for paroxetine, about 3 percent of adverse events were recorded, but individual data for patients actually revealed an incidence rate closer to 11 percent.
"Prescribing might help the doctor feel like he or she is doing something, or help parents feel that something is being done," says Jureidini. "But the adolescent might feel it to be dismissive of their distress."
He adds that there is little reason to think that antidepressants are better than nothing for kids and teens.
Meanwhile, study co-author Peng Xie says kids and teens should be monitored more closely regardless of the antidepressant they're taking.
Professor Shirley Reynolds of University of Reading says it is important that the benefits and risks of taking antidepressants are discussed with kids and teens.
"Once in treatment their symptoms, risk of self-harm and suicide, and well-being should be monitored at every treatment session and this should be discussed with them and help guide treatment," adds Reynolds.
Photo: Darcy Adelaide | Flickr