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Should young people be given antidepressants? No

BMJ 2007; 335 doi: (Published 11 October 2007) Cite this as: BMJ 2007;335:751
  1. Sami Timimi, consultant child and adolescent psychiatrist
  1. Lincolnshire Partnership NHS Trust, Sleaford, Lincolnshire NG34 8QA
  1. Correspondence to: stimimi{at}

    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 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 …

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