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Children and teenagers who are put on anti-depressants may face an increased risk of suicide, according to warnings by Australian and US authorities.
No antidepressants are currently approved for the treatment of children in Australia but doctors have the discretion to prescribe drugs like Prozac based on their assessment of individual cases.
Concern about the link between the drugs and suicidal tendencies in children and adolescents has been highlighted in a warning to American doctors from the US Food and Drug Administration (FDA).
The FDA warning follows a similar alert to Australian doctors from the federal Therapeutic Goods Administration (TGA).
Prozac is approved for paediatric depression in the US, but as in Australia, doctors are free to prescribe any approved drug and several are being tested in young patients.
The FDA said while there was no evidence to show most anti-depressants could cause a young person to commit suicide, doctors needed to be vigilant.
"The data do not clearly establish an association between the use of these drugs and increased suicidal thoughts or actions by paediatric patients," the FDA advised.
"Nevertheless, it is not possible at this point to rule out an increase of these adverse events for any of these drugs."
The FDA comments were based on a review of studies on the drugs Aropax, Prozac, citalapram (Celapram, Cipramil), Luvox, Remeron, Serzone, Zoloft and Efexor, all of which are available in Australia.
Clinical and research psychiatrist at the University of NSW, Ian Hickie, said anti-depressants were not widely prescribed to Australian children because they tended not to work on younger people.
He said specialists took evidence about the risk of the drugs in children and teenagers very seriously.
"In clinical trials, now that it's being monitored more closely, it looks like there may be an increase in the proportion of kids reporting suicidal ideation who are on the drugs," he said.
"The FDA is suggesting, as is the TGA, a very cautious approach, and doctors are already well aware of that."
However, it was also a matter of weighing the risks against the benefits, as some children may face an increased risk of suicide without the medication, Prof Hickie said.
©AAP 2003
No antidepressants are currently approved for the treatment of children in Australia but doctors have the discretion to prescribe drugs like Prozac based on their assessment of individual cases.
Concern about the link between the drugs and suicidal tendencies in children and adolescents has been highlighted in a warning to American doctors from the US Food and Drug Administration (FDA).
The FDA warning follows a similar alert to Australian doctors from the federal Therapeutic Goods Administration (TGA).
Prozac is approved for paediatric depression in the US, but as in Australia, doctors are free to prescribe any approved drug and several are being tested in young patients.
The FDA said while there was no evidence to show most anti-depressants could cause a young person to commit suicide, doctors needed to be vigilant.
"The data do not clearly establish an association between the use of these drugs and increased suicidal thoughts or actions by paediatric patients," the FDA advised.
"Nevertheless, it is not possible at this point to rule out an increase of these adverse events for any of these drugs."
The FDA comments were based on a review of studies on the drugs Aropax, Prozac, citalapram (Celapram, Cipramil), Luvox, Remeron, Serzone, Zoloft and Efexor, all of which are available in Australia.
Clinical and research psychiatrist at the University of NSW, Ian Hickie, said anti-depressants were not widely prescribed to Australian children because they tended not to work on younger people.
He said specialists took evidence about the risk of the drugs in children and teenagers very seriously.
"In clinical trials, now that it's being monitored more closely, it looks like there may be an increase in the proportion of kids reporting suicidal ideation who are on the drugs," he said.
"The FDA is suggesting, as is the TGA, a very cautious approach, and doctors are already well aware of that."
However, it was also a matter of weighing the risks against the benefits, as some children may face an increased risk of suicide without the medication, Prof Hickie said.
©AAP 2003
