BMJ  2007;335:751 (13 October), doi:10.1136/bmj.39316.406470.94

Feature

Head to head

Should young people be given antidepressants? No

Lincolnshire Partnership NHS Trust, Sleaford, Lincolnshire NG34 8QA

Depression is disabling a growing proportion of children, but evidence on treatment is disputed. Andrew Cotgrove believes drugs are a vital part of the armoury but Sami Timimi is unconvinced that they are helpful or safe

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

The medical profession had endorsed the use of selective serotonin reuptake inhibitors (SSRIs) well before any of the big studies in children were published.¹ Now that studies have been done, the evidence is clear: the drugs are not effective in young people and can increase suicidal behaviour. Continuing to use SSRIs in young people is not good value for money, dangerous, and ethically unsound.

It is well established that tricyclic antidepressants are not effective for childhood depression.² The evidence suggests SSRIs are no better. Jureidini and colleagues reported that none of the studies on SSRIs for childhood depression have, on outcome measures reported by patients or parents, showed significant advantage over placebo.³ No data regarding rates of self harm, presentations to emergency or mental health services, or school attendance were presented in any study they reviewed, leading them to conclude that investigators exaggerated the benefits and downplayed the dangers of . . . [Full text of this article]

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