Most antidepressants are ineffective in children

                

Most antidepressant drugs is ineffective in children and adolescents suffering from severe depression and may be possibly even dangerous, says a large study published on Thursday in the British medical journal The Lancet.

By an international group of researchers, the study reviewing 34 tests on more than 5,000 children and adolescents aged 9 to 18, involving 14 antidepressants.

Only one of these drugs, fluoxetine - mainly marketed as Prozac - was more effective than a placebo to treat the symptoms of depression.

Fluoxetine is also better tolerated than other antidepressants.

On the other hand, nortriptyline was considered the least effective of 14 antidepressants studied, and imipramine, unless tolerated. Already venlafaxine is associated with an increased risk of suicidal thoughts.

The researchers acknowledge, however, that the true efficacy and the risk of serious unwanted side effects of these drugs remain unknown in the field, due to the fragility of existing clinical trials.

This is the case especially of suicidal thoughts and behaviors linked to antidepressants.

In a comment added to the study, the Australian researcher Jon Jureidini pointed out that, with regard to paroxetine, they reach 10% in a new profile data, from 3% to previously published studies.

According to estimates cited by the study, 2.8% of children between 6 and 12 years and 5.6% of adolescents suffer from serious depression problems in developed countries. This number may be underestimated, taking into account the difficulty of diagnosing the disease.

These symptoms are different from those in adults and include, in particular, irritability, not wanting to go to school, or aggressive behavior.

Regarding antidepressants - which can also cause, in addition to suicidal ideation, headache, nausea and insomnia - your prescription is still increasing, although most Western countries advise, from now on, which are reserved for more depressions serious and after the failure of psychotherapies.

"Antidepressants do not seem to provide a clear benefit in children and adolescents," conclude the authors, adding that "Fluoxetine is probably the best option when drug therapy is indicated."

Several experts celebrated the results of the study, which strengthen the recommendations of countries like France or Britain, with regard to prescribing antidepressants to children and adolescents.

The first treatment of depression in both groups should remain "a psychological approach, or relational," which is "most effective in the long run," he told AFP the vice president of Psychiatry French Society of Children and Adolescents, Daniel Marcelli, who participated in the preparation of the French recommendations.

"We agree with the conclusions of the authors, who believe that antidepressants should be used sensibly and closely monitored," the British psychiatrist, Bernadka Dubicka.