Antidepressants Could Now Safely Be Prescribed To Children

A multidisciplinary team of researchers at Johns Hopkins University School of Medicine have developed two new strategies with an aim to gain a new understanding of how to mitigate the risk of suicide while on selective serotonin reuptake inhibitor class of medications, or SSRI. These new strategies will help in providing a better treatment for depressed children and young adults and are published the journal Translational Psychiatry.

Senior investigator Adam Kaplin, an assistant professor of psychiatry and neurology at the Johns Hopkins University School of Medicine, stated that depressed children and adolescents rarely seek help on their own. And when the parents realise that their children are facing depression, they might try other means of treatment before seeking medical attention.

And hence he believes that “These medications have to be dosed in a careful way to mitigate the negative effects of the medications since the treatment regimens for children and adolescents have tended to be more intense in order to treat depression quickly.” He further adds that “It is excruciatingly painful to wait for kids to respond when they are often already at the end of their ropes before meeting with a medical professional.”

SSRI treatment, however, has proved to increase the risk of suicidal thoughts and behavior ("suicidality") in children and adolescents. Thus, in 2004, the U.S. Food and Drug Administration, or FDA, issued a black box warning for SSRIs, cautioning people against the use of it.

Although more than 10 percent of all children and adolescents in the U.S. suffer from major depressive disorder, the clinicians hesitate to prescribe SSRI’s due to the black box warning .This might be one of the reasons for the suicide rates to go up because there seem to be a greater risk of suicide from leaving major depressive disorder untreated.

The study authors aimed at finding out whether these early negative effects that are observed after starting SSRIs could be mitigated either by the same kind of careful dosing or by combining the SSRI drugs with some other medication that had previously shown to hasten SSRIs' therapeutic effects in adults.

The team began their analysis by studying the same data the FDA used in 2004 to issue its black box warning. By doing so, they observed that young patients on SSRIs were more impulsive, particularly during the first month of treatment, but didn’t create new suicidal thoughts that were earlier absent.

While carrying out the research on mice, the researchers found that by adding a molecule called WAY-100635, it produced a synergistic effect when given with an SSRI and was able to alleviate the anxiety that they had. On treatment of SSRI, the levels of the hormone serotonin, a neurotransmitter, get reduced initially and after a long-term exposure, the levels increase .This stop-start mechanism, the researchers said, is the cause for anxiety and increased impulsiveness in children. They claim that coupling SSRI treatment with WAY-100635 will help eliminating the stop-start and creates a smoother transition.

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