High doses of antidepressants appear to increase risk of self-harm in children, young adults

[Shiloh]

Source: http://medicalxpress.com/news/2014-04-high-doses-antidepressants-self-harm-children.html

April 28, 2014
High doses of antidepressants appear to increase risk of self-harm in children young adult

Children and young adults who start antidepressant therapy at high doses, rather than the "modal" [average or typical] prescribed doses, appear to be at greater risk for suicidal behavior during the first 90 days of treatment.

A previous meta-analysis by the U.S. Food and Drug Administration (FDA) of antidepressant trials suggested that children who received antidepressants had twice the rate of suicidal ideation and behavior than children who were given a placebo. The authors of the current study sought to examine suicidal behavior and antidepressant dose, and whether risk depended on a patient's age.

The study used data from 162,625 people (between the ages of 10 to 64 years) with depression who started antidepressant treatment with a selective serotonin reuptake inhibitor at modal (the most prescribed doses on average) or at higher than modal doses from 1998 through 2010.

The rate of suicidal behavior (deliberate self-harm or DSH) among children and adults (24 years or younger) who started antidepressant therapy at high doses was about twice as high compared with a matched group of patients who received generally prescribed doses. The authors suggest this corresponds to about one additional event of DSH for every 150 patients treated with high-dose therapy. For adults 25 to 64 years old, the difference in risk for suicidal behavior was null. The study does not address why higher doses might lead to higher suicide risk...

 

[Giuseppe]

Re: High doses of antidepressants appear to increase risk of self-harm in children, young adults

Some of these drugs have precisely indicated in their instruction papers the possibility of an enhanced suicidal tendency, through lowering the overall anxiety level (that is in fact a self-defensive measure our brain has against self-harming), and by some other psichiatric disturbances arisen after the resolution of major depressive symptoms.

For this reason, a patient has to be carefully monitored by a trained doctor, who knows the history of the disease, from early stages to current status.

Antidepressants are drugs as all Others, so no one must be left alone to take them (imagine if people should start to get pills for infections, without control!).

All drugs with neurotropism have to be carefully prescribed and monitored in paediatric patients since the risk/benefit ratio has to be correctly evaluated.

Neurotrophic agents may induce several changes in hormones level and immune response that in paediatric patients could reach harmful level.

The great benefits from antidepressants and other neurotrophic agents need to be maintained through a correct awareness of the patients, doctors, and the entire community.

If not, people would start to blame these drugs for a lot of individual and societal disturbances that may not be their fault.

gm