Cardiovascular and neurological adverse events associated with antidepressant treatment in children and adolescents.
A retrospective cohort design of Medicaid medical and pharmacy claims for 1996 through 2005 was employed for 14,171 children and adolescents prescribed an antidepressant medication and a random sample of 4500 children not treated with any class of psychotropic medication to compare the prevalence rates of cardiovascular and neurological adverse events. The treated cohort evinced a higher prevalence of cardiovascular events, orthostatic hypotension, seizures, insomnia, and headaches. In the treated cohort, patients were at a significantly higher risk for incident cardiovascular events when exposed to selective serotonin reuptake inhibitors and weight-inducing antidepressants, mood stabilizers, and antipsychotics. Incident orthostatic hypotension was associated with weight-inducing antidepressants and mood stabilizers. Incident seizures and extrapyramidal symptoms were unrelated to antidepressant or co-prescribed psychotropic medications, but both were significantly associated with comorbid central nervous system, organic brain/mental retardation, or preexisting cardiovascular or cerebrovascular conditions. Headaches and dizziness were significantly related to taking mood stabilizers.
Jerrell
Jeanette M
JM
Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, South Carolina 29203, USA. jjerrell@gw.mp.sc.edu
McIntyre
Roger S
RS
D000293:Adolescent; D000928:Antidepressive Agents / Q000009:adverse effects*; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001835:Body Weight / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D002648:Child; D015331:Cohort Studies; D004244:Dizziness / Q000139:chemically induced; D005260:Female; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007024:Hypotension, Orthostatic / Q000139:chemically induced; D008607:Intellectual Disability; D008297:Male; D008484:Medicaid; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced*; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D014481:United States
D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D017367:Selective Serotonin Reuptake Inhibitors