New research is shedding light on the ongoing controversy over whether antidepressant medications help depressed children and adolescents—and how the benefits compare to the risk of suicidal impulses and attempts, reports the June issue of the Harvard Mental Health Letter.

Researchers examined data from placebo-controlled clinical trials involving 11 different drugs. Of more than 4,500 patients in 24 trials, none committed suicide. When all the studies were combined, patients taking the drugs showed slightly more suicidal tendencies.

Information is still coming in from pharmaceutical companies. For example, the maker of the antidepressant paroxetine (Paxil) recently reported that it found a link between this drug and suicidal behavior in adults. But clinicians and patients probably should respond cautiously to this news.

“It’s always hard to judge when an impulse is genuinely suicidal, and records from clinical trials make it more difficult, because the information is often incomplete. We need better research to know whether the small statistical differences are significant in practice,” says Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter.

While the use of antidepressants increased in the 1990s, the suicide rate among adolescents declined—coincidentally or not—by 31%. And recent autopsy studies have shown that adolescents who commit suicide, even when they have a prescription for an antidepressant, are usually not taking the drug at the time of death. A consensus seems to be emerging that the risk of suicide in children and adolescents taking antidepressants may have been exaggerated, says the Harvard Mental Health Letter.

For people of any age, the risk of leaving depression untreated may be greater than the risk of taking antidepressants. The best defense against side effects, including suicidal thoughts, is staying alert to the risks and consulting regularly with a physician.

Also in this issue:
Borderline personality disorder
• Gays’ mental health
• Variations in schizophrenia by place and population
• Predicting a lasting marriage
• Body size and suicide
• Placebos: Some better than others
• A doctor discusses: When the unconscious knows best

The Harvard Mental Health Letter is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $59 per year. Subscribe at or by calling 1-877-649-9457 (toll free).

Source: Harvard Mental Health Letter

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Contact: Christine Junge
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