Most SSRI Ineffective In Teens, And Some Very Dangerous

Discussion in 'Scientific Studies' started by haidut, Jun 9, 2016.

  1. haidut

    haidut Member

    Mar 18, 2013
    USA / Europe
    Not really surprising but at least the official evidence is piling up.

    Most antidepressants ineffective in teens, study finds

    "...Most antidepressants on the market are ineffective for children and teens with major depressive disorder, and some may be unsafe for young patients, according to new research published in The Lancet. The findings show that out of 14 antidepressants, only fluoxetine (sold under brand names Prozac and Sarafem) was more effective at relieving symptoms of depression in young people than a placebo pill. In contrast, taking venlafaxine (Effexor) was associated with an increased risk of suicidal thoughts and suicide attempts when compared to a placebo and five other antidepressants. The researchers say their study is the most comprehensive analysis to date of commonly prescribed antidepressant use in children and teens. However, they caution that the drugs' true effectiveness and potential for harms remain unclear because only a limited amount of research has been done on antidepressant use in children and teens."
  2. marteagal

    marteagal Member

    Feb 21, 2016
    Cool stuff, Haidut. Just adding two quotes from the study:

    "In terms of efficacy, only fluoxetine was better than placebo (SMD [standardised mean difference] –0.51, 95% CrI –0.99 to –0.03). [...] We found that only fluoxetine was significantly more effective than placebo, and the corresponding SMD of 0.51 is considered to be a medium effect size.22 However, the large credible interval and its upper limit close to the point of no difference raise the question of whether this estimate is robust enough to inform clinical practice. By comparison with placebo, fluoxetine was significantly more effective in trials without industry sponsors; however, a possible explanation is that trials without industry sponsors tend to have a smaller sample size, which might result in an exaggerated treatment effect.23"

    "[...] The findings of this comprehensive network meta-analysis provide some evidence that fluoxetine might reduce depressive symptoms in children and adolescents with major depressive disorder and the extent to which this reduction is clinically meaningful is still uncertain. Notwithstanding these caveats, fluoxetine might still be considered the best option among antidepressants when a pharmacological treatment is indicated. Other antidepressants do not seem to be suitable as routine treatment options. In the clinical care of young people with major depressive disorder, clinical guidelines recommend psychotherapy (especially cognitive-behavioural therapy or interpersonal therapy)4,5,29 as the first-line intervention, and fluoxetine should be considered only for patients with moderate-to-severe depression (especially adolescents)10 who do not have access to psychotherapy (eg, in low-income and middle-income countries)30 or have not responded to non-pharmacological interventions."

    Cipriani, A., Zhou, X., Del Giovane, C., Hetrick, S. E., Qin, B., Whittington, C., Coghill, D., Zhang, Y., Hazell, P., Leucht, S., Cuijpers, P., Pu, J., Cohen, D., Ravindran, A. V., Liu, Y., Michael, K. D., Yang, L., Liu, L., & Xie, P. (2016). Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: A network meta-analysis. Lancet.