Children and adolescents have a doubled risk of aggression and suicide when taking one of the five most commonly prescribed antidepressants, according to findings of a study published on January 27, 2016 in an open-access article in The BMJ. The article is titled “Suicidality and Aggression During Antidepressant Treatment: Systematic Review and Meta-Analyses Based on Clinical Study Reports.” Selective serotonin reuptake inhibitors (SSRIs) antidepressants and serotonin-norepinephrine reuptake inhibitors (SNRIs) are the most commonly prescribed drugs for depression. A team of researchers from Denmark recently carried out a systematic review and meta-analysis of 68 clinical study reports of 70 trials with 18,526 patients to examine use of antidepressants and associated serious harms. These included deaths, suicidal thoughts and attempts, as well as aggression and akathisia, a form of restlessness that may increase suicide and violence. The team examined double-blind placebo-controlled trials that contained patient narratives or individual patient listings of associated harms. Harms associated with antidepressants are often not included in published trial reports, explain the authors. This is why the researchers analyzed clinical study reports, prepared by pharmaceutical companies for market authorization, and summary trial reports, both of which usually include more information than the trial reports. In adults, the researchers found no significant associations between antidepressants and suicide and aggression. However, a novel finding showed there was a doubling of risk for aggression and suicides in children and adolescents. This study has shown limitations in trials, not only in design, but also in reporting of clinical study reports, which may have led to "serious under-estimation of the harms," write the authors.
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