Pharmacy

Teens and antidepressants – some research at last

Many children and teens stop taking medication for depression and anxiety before the end of the six-month period that is generally prescribed. But they shouldn’t, says Yola Moride, a professor in the Faculty of Pharmacy at the Université de Montréal. “If the treatment period is too short, undesirable side effects may occur before any compensating benefits are felt.” 
For the past five years, the researcher has been working with minors who suffer from depression, anxiety or other conditions for which antidepressants are prescribed. She has looked at data from the Régie de l’assurance-maladie (the Quebec health insurance board) and the Ministry of Health and Social Services on more than 5,000 children and 11,000 adolescents between the ages of two and 19 who were prescribed antidepressants between 1997 and 2005.

This is the broadest sampling to date of young Quebecers. “There is very little scientific literature on the risks and benefits of antidepressants for children and teens,” notes Moride. “That’s because the clinical trials that are conducted before drugs are launched on the market generally exclude young subjects. And that’s why we know so little about the subject.”

Twenty years after the advent of Prozac, the so-called happiness pill, there are still many questions but few answers. The use of such drugs as Paxil, Effexor and Celera is widespread today. The use of antidepressants by American teens and children under the age of 18 rose by 49% between 1998 and 2002, according to a study published in the journal Psychiatric Services in April 2004. In Canada, 1.8% of people between the ages of 15 and 19 are taking antidepressants, according to the Canadian Journal of Psychiatry, 2005.

“The use of these substances is recommended for the treatment of moderate to severe depression in this population despite many warnings from regulatory agencies on the serious side efforts that can occur, including the appearance of aggressive behaviours or suicide attempts,” notes Moride, who recently obtained $71,298 in funding from the Canadian Institutes of Health Research for her study on children and teens.

Preliminary findings from work with psychiatrist Marie Tournier, a postdoctoral fellow in Moride’s lab, show that the situation is just as disturbing for young people as it is for adults and seniors, the subjects of a similar study Moride conducted last year. “More than 50% of treatments using antidepressants aren’t long enough. This is particularly alarming when we consider the substantial risk of relapse,” says the professor, who wonders whether the diagnoses are correct and the treatments are always justified. “It seems, in any event, that there is a lack of medical follow-up, because many patients don’t go back to the doctor after they stop taking their pills,” she says.