April 18, 2004


Antidepressant Use in Children Soars Despite Efficacy Doubts (Shankar Vedantam, Washington Post, 18/04/04)

The number of depressed American children being treated with antidepressants has soared over the past decade -- a tectonic shift in the practice of psychiatry -- but new scientific reviews of the research that fueled the trend suggest that the drugs' benefits have been dramatically oversold.

The use of antidepressants among children grew three- to tenfold between 1987 and 1996, data from various studies indicate, and a newer survey found a further 50 percent rise in prescriptions between 1998 and 2002. The explosion in antidepressant use occurred even though the vast majority of clinical trials have failed to prove that the medicines help depressed children.

The spike in prescriptions over the past five years has been especially sharp among children younger than 6, even though there is virtually no clinical trial data on these youngest patients.

Paradoxically, drugs that have never shown benefits for depressed children in clinical trials have some of the largest increases in prescription rates. Pediatric prescriptions for Paxil, for example, doubled between 1998 and 2002, even though the medicine failed to show it was any better than dummy pills in three trials. The drug has not been approved for use in children, and last year the Food and Drug Administration and British health authorities warned physicians not to prescribe Paxil for children, citing safety concerns.

Paxil is not alone. Of 15 trials conducted among depressed children, 10 failed to show antidepressants were better than dummy pills. Two were inconclusive, and three showed positive results. The negative results have mostly been withheld from public scrutiny by the pharmaceutical companies that paid for the trials, which say that the data are proprietary.

Although many psychiatrists swear by the drugs in children and adults, leading specialists agree they have limitations.

The first line says it all by assuming there is a plague of young children suffering from a real disease called depression. What exactly is a depressed five year old? What kind of insane society actually believes this? Surely any parent or doctor that allows a young child to be medicated this way is guilty of child abuse.

Posted by Peter Burnet at April 18, 2004 9:13 AM

agreed. unfortunately, this sort of crap is taught in medical school. for many 'psych illnesses', the first response by students/interns/residents it to try an SSRI/SNRI, or some variation thereof, even before a true consult/diagnosis of 'depression' is established. i never understood why previous generations of doctors bemoaned the current flocks, but now i do.

welcome to the society that wants drugs to 'fix' any 'problem'. it's rather sad.

Posted by: poormedicalstudent at April 19, 2004 12:59 AM

Amazing how children grew into functioning adults in all those generations before Paxil & Ritalin, isn't it?

How children back then usually buried most of their siblings before adulthood and dealt with it without "grief counselors"?

Posted by: Ken at April 19, 2004 1:13 PM