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Danish researchers warn that the side effects of certain antidepressants may increase the risk of suicide when used by children.
In a study published in the medical journal The BMJ on on January 27, researchers from the University of Copenhagen and the Nordic Cochrane Centre in Denmark found that the use of antidepressants such as Zoloft, Paxil, Cymbalta, Effexor and Prozac doubled the risk of suicide and aggressive behavior in children.
All of the drugs, except Effexor, belong to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). Effexor is part of a closely related class known as serotonin and norepinephrine reuptake inhibitors.
Researchers looked at data on 70 different drug trials involving 18,526 patients. They found that while there were slight increases in the risk of death, and suicidality, aggression and akathisia (a movement disorder caused by restlessness) among adults, the increases were statistically insignificant.
In children using antidepressants, the findings were more pronounced. Children who used drugs like Zoloft, Paxil and Effexor were found to have more than twice the risk of death, suicide, restlessness and aggression, the researchers found.
“In adults there were no significant increases in all four outcomes, but in children and adolescents the risk of suicidality and aggression doubled,” the researchers warned. “To elucidate the harms reliably, access to anonymised individual patient data is needed.”
Researchers also warned that there were problems with trial reports and adverse events posted to Eli Lilly’s website regarding its Cymbalta and Prozac antidepressants, raising concerns about the information being provided to doctors and potential users.
“Information was limited on adverse events in these summary reports and it was not reliable,” the researchers noted. “The number of serious events was always mentioned but the cases were not always explained and the reports focused on the most common adverse events.”
In 2004, the FDA placed a “black box warning” on Prozac and other SSRI antidepressants, indicating that the drugs have been linked to an increased risk of suicide for children and young adults under the age of 25. The warning was based on the findings of 25 previous clinical trials that led to the conclusion.
SSRIs are a relatively new class of antidepressants, which help reduce symptoms of depression by preventing certain nerve cells in the brain from re-absorbing the chemical serotonin. These drugs are commonly used by millions of Americans with depression.
Although the drugs have been found to cause fewer side effects than older anti-depressants, previous studies have shown that users of the drugs could face an increased risk of suicides, and use during pregnancy has been linked to a risk of birth defects from SSRI antidepressants.