Antidepressants
Nikiforos Angelopoulos, a professor of psychiatry, is seen in his office in Athens April 25, 2012. In a country that has had one of the lowest suicide rates in the world, a surge in the number of suicides in the wake of an economic crisis has shocked and gripped the Mediterranean nation - and its media - before a May 6 election. Experts say the numbers are relatively low - less than about 600 per year. But increases in suicides, attempted suicides, the use of anti-depressant medication and the need for psychiatric care are causing alarm in a nation unaccustomed to the problems. Reuters/Erik Kirschbaum

A study says that children who are on one of the five most commonly prescribed antidepressants may face doubled risk of aggression and suicide. A Denmark team of researchers conducted a systematic review and meta-analysis of 68 clinical study reports. The study involved 18,526 patients and the experts studied their use of antidepressants and their associated health risks.

Serotonin-norepinephrine reuptake inhibitors (SNRIs) and Selective serotonin reuptake inhibitors (SSRIs) antidepressants are most commonly prescribed drugs for depression.

The study, published in the BMJ, showed that there was a doubling of risk for aggression and suicides in children and adolescents. The researchers did not find any significant association in adults between antidepressants and suicides and aggression.

The researchers next compared the results from the clinical study reports with data from individual patient listings or narratives of adverse effects. The comparison revealed misclassification of suicidal events and deaths in those taking antidepressants.

“The true risk for serious harms is still unknown [because] the low incidence of these rare events, and the poor design and reporting of the trials, makes it difficult to get accurate effect estimates,” the study pointed out.

The experts have recommended minimal use of the drugs in children, adolescents, and young adults. They are more than sure of the serious harm the antidepressants may cause and the harm is much greater than believed. That is because the effects of the drugs seem to be below what is relevant clinically. Alternative treatments such as psychotherapy and exercise should be taken up.

In order to form a more accurate and clear view of the benefits and bad effects of the drugs, hidden information in clinical reports must be identified. More than half of the clinical study reports did not have individual patient listings.

The researchers obtained clinical study reports for antidepressants fluoxetine, duloxetine, sertraline, paroxetine and venlafaxine from regulatory agencies in Europe and the UK. Summary trial reports for duloxetine and fluoxetine were taken from drug company Eli Lilly's website.

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