BMJ  2006;332:1464-1465 (24 June), doi:10.1136/bmj.332.7556.1464

Editorial

Rational prescribing for children

In an evidence based desert, safe and appropriate treatment is difficult and too easily exploited

The first 150 words of the full text of this article appear below.

Many drugs used to treat children are unlicensed or off label.¹ Three recent news stories highlight how children, like adults, are at risk from overprescribing and inappropriate prescribing. A systematic review conducted by the National Institute for Health and Clinical Excellence has shown fluoxetine (with or without cognitive behavioural therapy) to be the only selective serotonin reuptake inhibitor that is more effective than placebo in teenage patients with depression.² Furthermore, the US Food and Drug Administration and the Medicines Healthcare Products Regulatory Agency have shown that most randomised controlled trials have reported higher rates of "possibly suicide-related event" and "suicide attempt event" among adolescents and children taking selective serotonin reuptake inhibitors than in those taking placebo.³ The systematic review on fluoxetine included children as young as 7 years old and found no conclusive evidence of increased suicidal behaviour or ideation in studies lasting seven to 12 weeks.² It may . . . [Full text of this article]

Royal Free and University College Hospital Medical School, University College London, London NW3 2PF
(icsi@rfc.ucl.ac.uk)

School of Pharmacy and Institute of Child Health University of London, London WC1N 1AX

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• Rani, F., Murray, M. L., Byrne, P. J., Wong, I. C. K. (2008). Epidemiologic Features of Antipsychotic Prescribing to Children and Adolescents in Primary Care in the United Kingdom. Pediatrics 121: 1002-1009 [Abstract] [Full text]  
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Rapid Responses:

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rational psychotropic prescribing for children

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bmj.com, 23 Jun 2006 [Full text]

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