Must we fear antidepressants in adolescents?

Abstract

Introduction

Epidemiological studies have established that teenager's prevalence rates of major depression are significant (10%). The media has given a good deal of attention to the potential risks of antidepressants and their connection to increased suicidality (especially in children and adolescents). These concerns have had a significant impact on both the prescribing of antidepressants and the parental fears about their use. It is interesting to note that in large groups’ studies of adolescents treated with selective serotonin reuptake inhibitors there have been no evidence of increased suicidal risk.

Objective

Understand if there is a significant association between antidepressant treatment and suicidality in a 3-months follow-up study of the adolescent's consultation of Centro Hospitalar Lisboa Norte.

Methods

Analysis of 81 adolescents with an initial diagnosis of major depression treated with an antidepressant for at least 3 months.

Results

After the follow-up period there has been an improvement in sadness in 92.6% of the adolescents, a remission of death thoughts in 98.8% and an absence of suicides attempts. In 61.7%, it was necessary to introduce also an antipsychotic in a low dose and in 12.3% another antidepressant with a hypnotic effect.

Conclusion

It is clear that untreated major depression carries significant suffering and disability. Although treatment with antidepressants may take several weeks before clinical improvement appear and depression may worsen in the first days, its therapeutic effect should not be underestimated even if becomes necessary to add another medication in the first days. In evaluating these kinds of concerns, we must always differentiate between media hype and scientific data.

Disclosure of interest

The authors have not supplied their declaration of competing interest.