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Antidepressants Linked to Suicidal Thoughts in Kids

On June 10 the Department of Health in the United Kingdom warned that Paxil, named Seroxat in the U.K., must not be used for the treatment of pediatric depression. A new analysis of nine studies conducted by Paxil’s manufacturer, GlaxoSmithKline, showed that teenagers and children taking Paxil were more than three times as likely as those taking placebos to think about and attempt suicide. No deaths have been linked to the drug.

On June 19 the U.S. Food and Drug Administration announced an investigation. Officials urged that Paxil use among children and teenagers be discontinued gradually and only under medical supervision. The agency also noted that Paxil was not approved for treating severe pediatric depression anyway, and there is no evidence that it is effective for that use. The FDA drew its conclusions from the same nine studies the U.K. Department of Health used to issue its warning.

Two months later, the drug company Wyeth sent a letter to doctors warning of increased suicidal thoughts among youngsters in clinical trials of their drug Effexor.

The controversy has reopened an old debate about the safety of the class of antidepressants that seem to act on the mood-regulating brain chemical serotonin. When the drugs became available in the early 1990s, concerns about increased risk of suicidal behavior prompted the FDA to convene an ad hoc panel of 10 psychological experts to evaluate the drugs. The panel concluded that there was not enough evidence to connect the drugs with suicide, and the controversy subsided.

Antidepressants generally do not work in children as they do in adults. Ongoing brain development may be one reason.

Michael W. Robbins

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