Antidepressants use in children and adolescents and the risk of suicide

Wohlfarth, Tamar; Zwieten, Barbara J. van; Lekkerkerker, Frits J.F.; Wied, Christine C. Gispen‐de; Ruis, Jerry R.; Elferink, André; Storosum, Jitschak G.

doi:10.1016/j.euroneuro.2005.10.004

Cited by 47 publications

(22 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The use of Selective Serotonin Reuptake Inhibitors (SSRI, the most widely used pharmacological agents for the treatment of depression) in children and adolescents for treating depression include safety concerns. For instance the use of SSRIs was found to be associated with increased risk for suicidal behavior (Newman 2004;Richmond and Rosen 2005;Wohlfarth et al 2006). However, the number of depressed children and adolescents for whom psychotherapy/mental health counseling during outpatient visits are prescribed decreased significantly over time (Ma et al 2005).…”

Section: Introductionmentioning

confidence: 96%

Efficacy of a Problem-Solving Therapy for Depression and Suicide Potential in Adolescents and Young Adults

2007

View full text Add to dashboard Cite

Short-term and structured cognitive behavioral problem-solving therapy (PST) is a developmentally relevant mode of action for the treatment of emotional problems in young people. This study aimed at testing the efficacy of a problem-solving therapy in treating depression and suicide potential in adolescents and young adults. A total of 46 self-referred high school and university students who were randomly assigned to a problem-solving therapy (n = 27) and a waiting list control (n = 19) conditions completed a controlled cognitive behavioral problem-solving treatment trial. Participants were administered the measures of depression, suicide potential, problem solving, self-esteem and assertiveness. Twenty-two of the 27 participants from the PST condition could be reached after 12-months for follow-up. Participants completed depression and problem-solving measures at follow-up. Results showed that post-treatment depression and suicide risk scores of participants within the PST condition decreased significantly compared to the pre-treatment scores but post-waiting and pre-waiting depression and suicide risk scores of participants within the WLC condition were unchanged. Likewise, post-treatment self-esteem and assertiveness scores of participants within the PST condition increased significantly compared to the pre-treatment scores while post-waiting and pre-waiting self-esteem and assertiveness scores of participants within the WLC condition were unchanged. At post-treatment, 77.8% of the participants in the PST but only 15.8% of those in the WLC condition achieved full or partial recovery according to BDI scores. Similarly, 96.3% of participants in the PST but only 21.1% of those in the WLC condition achieved full or partial recovery according to HDRS scores. The improvements were maintained at 12-months follow-up. Therefore, it is concluded that problem-solving therapy should be considered as a viable option for the treatment of depression and suicide potential in adolescents and young adults.

show abstract

Section: Introductionmentioning

confidence: 96%

Efficacy of a Problem-Solving Therapy for Depression and Suicide Potential in Adolescents and Young Adults

2007

View full text Add to dashboard Cite

show abstract

“…Indeed, the efficacy of selective serotonin (5-HT) reuptake inhibitors (SSRIs) in the treatment of pediatric depression is still disputed [5]–[9] while tricyclic antidepressants have been shown to be ineffective [10]. In addition, clinical studies have raised concerns about increases in suicidal ideation and behavior in children and adolescents treated with SSRIs [11]–[13] and also increased agitation, depression and anxiety [12] as well as negative effects on growth rate [14] have been described. This apparent heightened sensitivity to adverse effects has even led to governmental warnings on the use of antidepressants in youngsters.…”

Section: Introductionmentioning

confidence: 99%

Increased Response to a 5-HT Challenge After Discontinuation of Chronic Serotonin Uptake Inhibition in the Adult and Adolescent Rat Brain

et al. 2014

View full text Add to dashboard Cite

Little is known about the effects of chronic fluoxetine on 5-HT transmission in the adolescent brain, even though it is acknowledged that the neuroplasticity of the brain during childhood and adolescence might influence the neurobiological mechanisms underlying treatment response. Also, possible ongoing effects on monoamine function following drug discontinuation are unidentified. We therefore examined the chronic effects of fluoxetine on extracellular 5-HT and dopamine concentrations in the medial prefrontal cortex and studied their responsiveness to an acute 5-HT challenge after a one-week washout period, both in adolescent and adult rats. Noradrenaline was measured in adult animals only. Fluoxetine increased 5-HT to 200–300% of control and DA and NA to 150% of control. Although there were no lasting effects of chronic fluoxetine on basal monoamine levels, we observed a clear potentiating effect of previous treatment on the fluoxetine-induced increase in extracellular 5-HT and, to a lesser extent, extracellular DA. No differential effect was found for noradrenaline. Age-at-treatment did not influence these results. So, after cessation of chronic fluoxetine treatment 5-HT responsiveness remains heightened. This may be indicative of the continuing presence of 5-HT receptor desensitization, at least until one week after drug discontinuation in rats. No apparent age-at-treatment effects on extracellular monoamine concentrations in the medial prefrontal cortex were detected, but age-related differences in 5-HT transmission further down-stream or in the recovery processes cannot be ruled out.

show abstract

“…Especially the potential for an increased suicide risk in association with SSRIs in general has led to much debate [89], as has also been pointed out by the Medicines Evaluation Board of the Netherlands [90] and several comments in the Lancet in response to an article by Ebmeier and colleagues [91]. …”

Section: Discussionmentioning

confidence: 99%

The effects of Psychotropic drugs On Developing brain (ePOD) study: methods and design

et al. 2014

View full text Add to dashboard Cite

BackgroundAnimal studies have shown that methylphenidate (MPH) and fluoxetine (FLX) have different effects on dopaminergic and serotonergic system in the developing brain compared to the developed brain. The effects of Psychotropic drugs On the Developing brain (ePOD) study is a combination of different approaches to determine whether there are related findings in humans.Methods/DesignAnimal studies were carried out to investigate age-related effects of psychotropic drugs and to validate new neuroimaging techniques. In addition, we set up two double-blind placebo controlled clinical trials with MPH in 50 boys (10–12 years) and 50 young men (23–40 years) suffering from ADHD (ePOD-MPH) and with FLX in 40 girls (12–14 years) and 40 young women (23–40 years) suffering from depression and anxiety disorders (ePOD-SSRI). Trial registration numbers are: Nederlands Trial Register NTR3103 and NTR2111. A cross-sectional cohort study on age-related effects of these psychotropic medications in patients who have been treated previously with MPH or FLX (ePOD-Pharmo) is also ongoing. The effects of psychotropic drugs on the developing brain are studied using neuroimaging techniques together with neuropsychological and psychiatric assessments of cognition, behavior and emotion. All assessments take place before, during (only in case of MPH) and after chronic treatment.DiscussionThe combined results of these approaches will provide new insight into the modulating effect of MPH and FLX on brain development.

show abstract

Antidepressants use in children and adolescents and the risk of suicide

Cited by 47 publications

References 18 publications

Efficacy of a Problem-Solving Therapy for Depression and Suicide Potential in Adolescents and Young Adults

Efficacy of a Problem-Solving Therapy for Depression and Suicide Potential in Adolescents and Young Adults

Increased Response to a 5-HT Challenge After Discontinuation of Chronic Serotonin Uptake Inhibition in the Adult and Adolescent Rat Brain

The effects of Psychotropic drugs On Developing brain (ePOD) study: methods and design

Contact Info

Product

Resources

About