Teenage antidepressants 'doing more harm than good'

From BBC - February 4, 2018

A leading expert in psychiatric medication has said the growing prescription of antidepressants to teenagers is doing more harm than good.

Prof David Healy questioned why they were being given the medication when clinical trial results were so poor.

Last year, figures obtained by BBC Scotland showed more than 5,500 under-18s in Scotland were prescribed antidepressants.

The Royal College of Psychiatrists said the drugs were an important option.

They said medicines for mental health - just like for physical health - carried risk but guidelines were evidence-based.

Antidepressants were only prescribed to children with great caution and under close supervision, they said.

'Commonly used'

However, Prof Healy told a global health conference in Aberdeen that - in 29 paediatric clinical trials of antidepressants - every single one failed to produce an obvious benefit.

He said: "At the same time, in every single one of these trials it has produced more harms than benefits in the sense that it has made children become suicidal who would not have become suicidal if they had not been put on these drugs."

Prof Healy said: "We have a situation where if you are following the evidence no-one should be using these drugs.

"At the same time, in teenagers, these drugs have become the most commonly used drugs."

Figures obtained by the BBC showed the number of children under 18 being prescribed antidepressants doubled from 2,748 in 2009/10 to 5,572 in 2016.

The number of children under 13 given antidepressants went up from 57 to 252 in the same period.

The Scottish government said the rise reflected the substantial increase in demand for child and adolescent mental health services in the past decade.

The statistics showed 45% of the under-18s were prescribed fluoxetine, which is usually sold under the trade name Prozac.

It is the only drug recommended for under 18s "as this is the only antidepressant for which clinical trial evidence shows the benefits outweigh the risks".

Even then it should not be prescribed until psychological therapy has been tried for three months and not worked.

Prof Healy also questions the evidence base for fluoxetine, saying the two apparently favourable paediatric trials on the drug actually failed to show benefit on the main measurements, known in science as "primary outcomes".

He said there have been a further seven paediatric trials since its licence was issued and fluoxetine has failed to show benefit in any of these.

'Absolutely astonished'

Dr Jane Morris, a consultant psychiatrist at Aberdeen's Royal Cornhill Hospital, said adolescents should definitely have the option of antidepressants alongside therapy and counselling.

She said: "I think they should be particularly carefully selected medications and I think they should be prescribed not only for cases of depression but perhaps even more when a person has extreme anxiety and obsessionality, because there is a very good evidence base for that."

Dr Morris said she was "absolutely astonished" by the way Prof Healy had interpreted the literature on antidepressants.

'It was a traumatic experience'

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