A Vanderbilt University Medical Centre
study released today shows there is no evidence that the risk of suicide
differs with two commonly prescribed anti-depressants prescribed to children
The population-based study, published today
in the journal Paediatrics, tracked children and adolescents who recently began
taking selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).
For the past decade parents and health care
professionals have worried that children and adolescents treated with
antidepressant medications might be at increased risk of suicidal thoughts or behaviour.
In 2004 The US Food and Drug Administration
(FDA) and the UK Medicine Healthcare Products Regulatory Agency issued public
warnings about the increased risk of suicidal thoughts or behaviour in children
and adolescents treated with certain anti-depressant medications, and required
that a boxed "black box" warning be added to package inserts for
medications might differ
Because anti-depressants differ in their
characteristics, including effects on neuro-transmitters, it has also been
believed that the risk of suicidal behaviour for individual medications might
"It is important to study this group
of children and adolescents because many children are treated with these
medications in the US each year and we need to understand the differential
risks for suicide attempts and completed suicides," said study author
William Cooper, M.D., MPH, Cornelius Vanderbilt Professor of Paediatrics and
professor of Health Policy.
on anti-depressants often relapse
SSRIs, like fluoxetine, are the most widely
used antidepressants/anti-anxiety drugs, slowing down the rate at which
serotonin, an important signalling molecule in the brain, is broken down. An
SNRI, like sertraline, is a newer type of antidepressant that does the same
thing for another important chemical, noradrenaline, as well as serotonin.
might be the culprit
Major depressive disorder (MDD) is common
in children and adolescents and has significant negative impacts on children's
development, functioning and risk for suicide, Cooper said.
According to the American Academy of Child
and Adolescent Psychiatry, suicide is the third leading cause of death for
15-24 year olds and the sixth leading cause of death for 5-14 year olds.
The Vanderbilt study reviewed the medical
records of 36,842 children 6 to 18 years old enrolled in Medicaid between 1995
and 2006 who were new users of one of the antidepressant medications of
interest. Of those studied 415 had a medically treated suicide attempt, including
four who completed suicide.
- The facts
Of those included in the study, 47.4% had a
diagnosis of MDD and one-fourth had a diagnosis of
attention-deficit/hyperactivity disorder. Other common psychiatric conditions
among the cohort members included conduct disorder and anxiety.
The study was not designed to compare the
risk for suicide attempts for antidepressant users compared with non-users.
"These findings provide important
information about the relative risks of the more recently approved
antidepressants to help guide decision making by patients, their families and
their providers," Cooper said. "But more research is needed to
understand other safety aspects of medications used to treat children so that
families and providers can make informed decisions."
Read More:Antidepressant/suicide link
Kids' suicide risk same for all antidepressants