Anti-Depressants May Increase Risk of Child Suicide

Children who take antidepressants run a higher risk of self-harm and attempting suicide, says new research. The findings from a study of almost 3,000 children – some as young as six – will reinforce warnings to doctors not to prescribe medication to youngsters.

Instead they are advised to offer talking therapies first, with pills as a last resort.

A team of Manchester University researchers carried out a new analysis of trials lasting eight to 12 weeks which involved children and adolescents suffering severe depression.

They found five per cent of children taking new-generation antidepressants were involved in self-harm or suicidal events, compared with three per cent of those taking dummy pills.

Altogether 71 of 1,487 depressed young people taking medication reported self-harm, suicidal thoughts or attempts compared with 38 of 1,254 of young people given placebo.

No child committed suicide in either group, says the study published today in the British Journal of Psychiatry.

The antidepressants involved were fluoxetine (also known by the brand name Prozac), sertraline (Lustral), citalopram (Cipramil), paroxetine (Seroxat) , venlafaxine (Efexor) and mirtazapine (Zispin).

Doctors are advised not to prescribe the majority of antidepressants, known as selective serotonin reuptake inhibitors (SSRIs) to children, although they may still use Prozac.

A ban was brought in on using most SSRIs in under-18s by Government health chiefs almost three years ago because of fears over harmful side-effects, when the number of prescriptions had risen to 170,000.

Last year guidelines from the National Institute for Health and Clinical Excellence (NICE) said children should be offered psychological therapy for depression, with pills only used for those who do not respond.

But it is estimated that 40,000 children and adolescents are still currently taking antidepressants – with half receiving no psychological support.

Around one in 10 young people suffers some form of mental illness, although there has been concern that some children who are just unhappy have been labelled as depressed – leading to thousands getting drugs which may increase the risk of suicidal behaviour.

Dr Bernadka Dubicka, who headed the study, said “There was a small increased risk – almost a doubling – of self-harm and suicidal thoughts and acts among children taking antidepressants.

“But we are not saying that children should never be treated with antidepressants because we should remember that depression is the number one cause of completed suicide, it’s a serious disorder.

“However, doctors treating depressed children and adolescents with new-generation antidepressants should carefully monitor suicide risk,” she said.

She said the research data taken from US studies was still ‘inconclusive’ because they covered only a short period of time.

“It can take six weeks for antidepressants to take effect so it may be that children on antidepressants experienced adverse effects during that time, before any positive effect happened.

“We need further studies that do not exclude the most depressed suicidal children, as most of the published trials do,” she said.

Dr Dubicka said the trials included Prozac, which is the only drug approved for children in the UK.

She said: “It appeared to have the same effects as the other drugs but was approved because there is a lot more data than the other drugs showing its positive effects.”

Psychiatrists were using antipdepressants to help children ‘with caution’, she said.

“Personally I only prescribe Prozac and regular monitoring is essential, at least weekly with checks on whether the child is experiencing suicidal thoughts,” she said.