Majority of anti-depressants 'not suitable' for under-18s

The majority of the most commonly prescribed type of anti-depressants - selective serotonin reuptake inhibitors (SSRIs) - are not suitable for use by under 18s, according to Alasdair Breckenridge, Chair of the Medicines and Healthcare products Regulatory Agency.

The new advice follows a review by a group of medical experts set up earlier this year to look at the safety of SSRIs. The group has now studied all available evidence and has found that risks of treating depressive illness in under 18's with certain SSRIs "outweigh the benefits of treatment".

There is no, or insufficient, evidence from clinical trials that benefits outweigh the risks of side effects for sertraline (Lustral), citalopram (Cipramil), escitalopram (Cipralex) and fluvoxamine (Faverin), the group said.

However, Fluoxetine, or Prozac, "appears to have a positive balance of risks and benefits" in the treatment of depressive illness in the under 18s.

An estimated 30,000 to 40,000 children and teenagers are prescribed SSRI's across the UK, and about half of those were treated with fluoxetine (Prozac). In June, a warning was issued about the use of paroxetine (Seroxat) in children under the age of 18, and further advice was given in September about the use of venflaxine (Efexor). Today's advice completes the picture on the remaining five SSRIs.

Professor Gordon Duff, Chairman of the Committee on Safety of Medicines, said: "The CSM Expert Group has delivered comprehensive advice on the use of these drugs in children and young people following a thorough review of all the evidence available. This gives parents, young people and those who treat these devastating illnesses the information they need to make informed decisions about treatment."

The Expert Group is now focusing on the ongoing review of the efficacy and safety of SSRIs in adults, and this should be completed in the first half of next year.

(gmcg)