Antidepressants may double risk of aggression, suicide in kids

Commonly prescribed antidepressants may double the risk of aggression and suicide in children and adolescents, researchers including one of Indian-origin have warned.
Selective serotonin reuptake inhibitors antidepressants (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are the most commonly prescribed drugs for depression.
Researchers from Nordic Cochrane Centre in Denmark 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.
They 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, researchers said.

In adults, they 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.
The study has shown limitations in trials, not only in design, but also in reporting of clinical study reports, which may have lead to "serious under-estimation of the harms," researchers said.
They compared the results from the clinical study reports with data from individual patient listings or narratives of adverse effects. This showed misclassification of deaths and suicidal events in people taking antidepressants.

For example, four deaths were misreported by a pharmaceutical company, in all cases favouring the antidepressant, and more than half of the suicide attempts and suicidal ideation, for example, were coded as "emotional lability" or "worsening of depression."
"The analysis suggests that clinical study reports, on which decisions about market authorisation are based, are likely to underestimate the extent of drug related harms," Tarang Sharma from the Nordic Cochrane Centre told 'The Telegraph.'
The study was published in the journal BMJ.