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Panel: SSRIs don't increase teen suicide risk

A report calls for the Food and Drug Administration to release all data on the use of these drugs for treating depression in young people.

By Susan J. Landers, amednews staff. Feb. 9, 2004.

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Washington -- Jumping into the debate over the pros and cons of prescribing a popular group of antidepressants to children and adolescents, an American College of Neuropsychopharmacology task force concluded that selective serotonin reuptake inhibitors do not increase teens' risk of suicidal thinking or suicide attempts and are effective in treating depression in this population.

The group's preliminary report runs counter to advisories issued last year by the U.S. Food and Drug Administration and its counterpart in the United Kingdom, which cautioned physicians about prescribing the antidepressants for children younger than 18.

The government agencies were acting on reports of a possible increase in suicidal thinking and suicide attempts among children and adolescents who were treated with certain of the SSRIs.

"At the heart of the issue is the fundamental medical principle 'do no harm,' " said J. John Mann, MD, co-chair of the ACNP panel that produced the report and a professor of psychiatry at Columbia University in New York City. Dr. Mann spoke at a Jan. 21 press briefing. "The question is, in treating these kids for depression -- which we must do -- can we do that in a way that does them more good than harm?"

That question has drawn a complicated set of responses. Britain, for example, had warned physicians against prescribing any SSRI antidepressant drug except fluoxetine (Prozac), for depressed youth younger than 18, while the FDA warned against the use of one SSRI, paroxetine (Paxil), but stopped short of warning against the use of other SSRIs. The U.S. agency has approved Prozac for treating children with depression, and its review of three trials determined that Paxil was no more effective than a placebo in treating depressed children and teens.