The use of anti-depressants for children is a “disaster”, says the leading medical journal The Lancet. In an article in its latest issue, six psychiatrists and child health experts suggest that drug companies may have suppressed evidence that many selective serotonin reuptake inhibitors, or SSRIs, are unsuitable or even dangerous for children. The research team , headed by Dr Craig Whittingdon from University College London, say that benefits outweighed risks for only one of the five SSRIs studied, Prozac (or fluoxetine). For three of the other four, paroxetine, citalopram and venlafaxine, there was clear evidence of a small risk of suicide-related events. For the drug sertraline there was a weak association with suicide.

Last year the UK Committee on Safety of Medicines banned the treatment of childhood depression with any of these drugs except Prozac. The Food and Drug Administration in the US has not acted on the issue.

However, the Washington Post reports that there is much uneasiness amongst American doctors about prescribing anti-depressants for children. The number of children who are being treated with anti- depressants has soared over the past 10 years in the US — perhaps three to ten-fold between 1987 and 1996, according to various studies. And between 1998 and 2002 it may have risen another 50%. This has happened despite growing evidence that the benefits of anti-depressants have been oversold. “Paradoxically, drugs that have never shown benefits for depressed children in clinical trials have some of the largest increases in prescription rates,” says the Post.

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