Antidepressants and suicide in children and adolescents: A storm in a teacup?

Simple item page
dc.contributor.authorSeedat S.
dc.date.accessioned2011-05-15T15:57:46Z
dc.date.available2011-05-15T15:57:46Z
dc.date.issued2004
dc.description.abstractSo have the regulatory authorities overstated the risks and underestimated the benefits of antidepressants in the treatment of depression in youth? Considering that existing data from clinical trials on suicidality appear contradictory and incomplete, more careful scrutiny of the risks and benefits is clearly needed. Better data and a cleaner, more systematic approach toward adverse event data reporting may be able to answer the question at hand. Risk benefit analyses in paediatric trials may be more complicated because of high placebo response rates which make it difficult to show statistically and clinically significant drug-placebo differences. For example, in two recent randomised controlled trials of sertraline in children and adolescents (aged 6 - 17) with DSM-IV defined major depressive disorder, undertaken at the request of the FDA, 69% of those who were taking sertraline were classified as responders compared with 59% of patients taking placebo. While these differences were statistically significant, the mean change in scores from baseline to endpoint on the primary outcome measure, the Children's Depression Rating Scale-Revised, between the groups was so small so as to be of minimal clinical significance. In addition to high placebo response rates, other problems include non-publication of negative findings, withholding of unfavourable data and under-reporting of adverse events. For now, monitoring child, adolescent, and adult patients closely for suicidal ideation during the first weeks of antidepressant therapy and during dose titrations of their medication should always be part of the armamentarium and standard of care of any good clinician.
dc.description.versionEditorial
dc.identifier.citationSouth African Journal of Psychiatry
dc.identifier.citation10
dc.identifier.citation3
dc.identifier.issn16089685
dc.identifier.urihttp://hdl.handle.net/10019.1/10593
dc.subjectamfebutamone
dc.subjectantidepressant agent
dc.subjectcitalopram
dc.subjectescitalopram
dc.subjectfluoxetine
dc.subjectfluvoxamine
dc.subjectmirtazapine
dc.subjectnefazodone
dc.subjectparoxetine
dc.subjectserotonin uptake inhibitor
dc.subjectsertraline
dc.subjecttricyclic antidepressant agent
dc.subjectvenlafaxine
dc.subjectadolescent
dc.subjectagitation
dc.subjectakathisia
dc.subjectanxiety disorder
dc.subjectautomutilation
dc.subjectclinical trial
dc.subjectdrug labeling
dc.subjectdrug packaging
dc.subjectdrug safety
dc.subjectdrug surveillance program
dc.subjecteditorial
dc.subjectfood and drug administration
dc.subjecthostility
dc.subjecthuman
dc.subjectimpulsiveness
dc.subjectinsomnia
dc.subjectirritability
dc.subjectmajor depression
dc.subjectoutcomes research
dc.subjectpanic
dc.subjectpatient care
dc.subjectpatient monitoring
dc.subjectpsychiatric diagnosis
dc.subjectrating scale
dc.subjectrestlessness
dc.subjectrisk assessment
dc.subjectrisk benefit analysis
dc.subjectscoring system
dc.subjectstandardization
dc.subjectstatistical significance
dc.subjectsuicidal behavior
dc.subjectsuicide attempt
dc.titleAntidepressants and suicide in children and adolescents: A storm in a teacup?
dc.typeEditorial
Files
Collections
Stellenbosch University - Scopus Publications