Children and adolescents have a doubled risk of aggression and suicide when taking one of the five most commonly-prescribed antidepressants, according to Danish researchers.
Their research focused on previous trials involving selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors.
“The true risk for serious harms is still unknown”
They noted that the true risk for all associated serious harms – such as deaths, aggression, akathisia and suicidal thoughts and attempts – remained unknown for children, adolescents and adults.
This, they claimed, was because of the poor design of trials that assessed these antidepressants, and the misreporting of findings in published articles.
The researchers, from the Nordic Cochrane Institute in Copenhagen, reviewed 70 trials with 18,526 patients to examine use of antidepressants and associated serious harms.
Harms included deaths, suicidal thoughts and attempts as well as aggression and akathisia, a form of restlessness that may increase suicide and violence.
They examined double blind placebo controlled trials that contained patient narratives or individual patient listings of associated harms.
In adults, they found no significant associations between antidepressants and suicide and aggression. However, they identified a doubling of risk for aggression and suicides in children and adolescents.
“The true risk for serious harms is still unknown [because] the low incidence of these rare events, and the poor design and reporting of the trials, makes it difficult to get accurate effect estimates,” said the study authors in the British Medical Journal.
They recommended “minimal use of antidepressants in children, adolescents, and young adults, as the serious harms seem to be greater, and as their effect seems to be below what is clinically relevant”, and suggest alternative treatments such as exercise or psychotherapy.
They also called for the need to identify “hidden information in clinical study reports to form a more accurate view of the benefits and harms of drugs”.