- Last edited on January 11, 2024
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meds:antidepressants:home [on January 11, 2024] psychdb [Suicide] |
meds:antidepressants:home [on January 11, 2024] psychdb [Suicide] |
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| </alert> | </alert> | ||
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| * Although there is no evidence of increased suicidal behaviours in adults, it is more clear that antidepressant use in the [[mood:1-depression:pediatric-child-adolescent|pediatric and young adult (age <24 years) population]] can result in increased agitation and suicidal behaviours. | * Although there is no evidence of increased suicidal behaviours in adults, it is more clear that antidepressant use in the [[mood:1-depression:pediatric-child-adolescent|pediatric and young adult (age <24 years) population]] can result in increased agitation and suicidal behaviours. | ||
| * In 2003, the FDA issued a black-box warning because a meta-analysis found a 1.5 to 2-fold increase in increased suicidal thoughts/behaviours (although there was no increased incidence of suicide deaths). | * In 2003, the FDA issued a black-box warning because a meta-analysis found a 1.5 to 2-fold increase in increased suicidal thoughts/behaviours (although there was no increased incidence of suicide deaths). | ||
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| * In the United States, fluoxetine is the only antidepressant approved by the FDA for preadolescents (8 years and older) and escitalopram is also approved for children 12 years and older. | * In the United States, fluoxetine is the only antidepressant approved by the FDA for preadolescents (8 years and older) and escitalopram is also approved for children 12 years and older. | ||
| * It is important to have a clear risk-benefit discussion between clinicians and their patients under these circumstances | * It is important to have a clear risk-benefit discussion between clinicians and their patients under these circumstances | ||
| + | </WRAP> | ||
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| <callout type="danger" title="Study 329: A Story of Pharmaceutical Influence" icon="true"> | <callout type="danger" title="Study 329: A Story of Pharmaceutical Influence" icon="true"> | ||
| A re-analysis in 2015 of Study 329 on the efficacy and safety of [[meds:antidepressants:ssri:paroxetine|paroxetine]] for children and adolescents showed that paroxetine was neither safe nor efficacious.[([[http://www.bmj.com/content/351/bmj.h4320|Le Noury, J., Nardo, J. M., Healy, D., Jureidini, J., Raven, M., Tufanaru, C., & Abi-Jaoude, E. (2015). Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence. Bmj, 351, h4320.]])] In fact, there was significant harm exposed to children, including increased suicidal ideation and behaviour. This case is a reminder to clinicians of the large role that[[teaching:pharmaceutical-industry-influence|pharmaceutical influence]] still has on healthcare. | A re-analysis in 2015 of Study 329 on the efficacy and safety of [[meds:antidepressants:ssri:paroxetine|paroxetine]] for children and adolescents showed that paroxetine was neither safe nor efficacious.[([[http://www.bmj.com/content/351/bmj.h4320|Le Noury, J., Nardo, J. M., Healy, D., Jureidini, J., Raven, M., Tufanaru, C., & Abi-Jaoude, E. (2015). Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence. Bmj, 351, h4320.]])] In fact, there was significant harm exposed to children, including increased suicidal ideation and behaviour. This case is a reminder to clinicians of the large role that[[teaching:pharmaceutical-industry-influence|pharmaceutical influence]] still has on healthcare. | ||
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| * {{ :meds:antidepressants:baldessarini_r._j._tondo_l._strombom_i._m._dominguez_s._fawcett_j._licinio_j._..._tohen_m._2007_._ecological_studies_of_antidepressant_treatment_and_suicidal_risks._harvard_review_of_psychiatry_15_4_133-145..pdf |Baldessarini, R. J., Tondo, L., Strombom, I. M., Dominguez, S., Fawcett, J., Licinio, J., ... & Tohen, M. (2007). Ecological studies of antidepressant treatment and suicidal risks. Harvard review of psychiatry, 15(4), 133-145.}}[([[https://www.ncbi.nlm.nih.gov/pubmed/17687708|Baldessarini, R. J., Tondo, L., Strombom, I. M., Dominguez, S., Fawcett, J., Licinio, J., ... & Tohen, M. (2007). Ecological studies of antidepressant treatment and suicidal risks. Harvard review of psychiatry, 15(4), 133-145.]])] | * {{ :meds:antidepressants:baldessarini_r._j._tondo_l._strombom_i._m._dominguez_s._fawcett_j._licinio_j._..._tohen_m._2007_._ecological_studies_of_antidepressant_treatment_and_suicidal_risks._harvard_review_of_psychiatry_15_4_133-145..pdf |Baldessarini, R. J., Tondo, L., Strombom, I. M., Dominguez, S., Fawcett, J., Licinio, J., ... & Tohen, M. (2007). Ecological studies of antidepressant treatment and suicidal risks. Harvard review of psychiatry, 15(4), 133-145.}}[([[https://www.ncbi.nlm.nih.gov/pubmed/17687708|Baldessarini, R. J., Tondo, L., Strombom, I. M., Dominguez, S., Fawcett, J., Licinio, J., ... & Tohen, M. (2007). Ecological studies of antidepressant treatment and suicidal risks. Harvard review of psychiatry, 15(4), 133-145.]])] | ||
| </callout> | </callout> | ||
| + | </WRAP> | ||
| + | </WRAP> | ||
| ==== Fetal Effects ==== | ==== Fetal Effects ==== | ||
| <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success"> | <alert icon="fa fa-arrow-circle-right fa-lg fa-fw" type="success"> | ||