[Suicidality in depressive children and adolescents during treatment with selective serotonin reuptake inhibitors. Review and meta-analysis of the available randomised, placebo controlled trials].
Due to concerns that selective serotonin reuptake inhibitors (SSRI) might be associated with an increased risk of suicidal ideation and suicide attempts in depressive children and adolescents, treatment with these drugs is controversial. All available data from randomised controlled trials on SSRIs treating depression in these age groups were examined regarding efficacy and suicidality. Results suggest that fluoxetine and, less clearly, sertraline are effective in such treatment. A meta-analysis yielded no statistically significant difference between treatment with SSRI and placebo with regard to the occurrence of suicidal behavior. Following evidence-based criteria, the risk:benefit ratio is favourable for fluoxetine and sertraline. Their use in the pharmacotherapy of depressive children and adolescents is indicated.
Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main. holtmann@em.uni-frankfurt.de
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Holtmann
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Bölte
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Poustka
D000293:Adolescent; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015990:Placebo Effect; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*
D018687:Antidepressive Agents, Second-Generation; D017367:Selective Serotonin Reuptake Inhibitors