Kids and Antidepressants: More Good Than Harm? Some experts argue that antidepressants may cause suicidal thoughts in young patients. But a new analysis of data contends that these medications are a help for most depressed children and adolescents.
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Kids and Antidepressants: More Good Than Harm?

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Kids and Antidepressants: More Good Than Harm?

Kids and Antidepressants: More Good Than Harm?

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In the past few years, there's been an impassioned debate over the safety of antidepressants for children and teens. Both proponents and opponents of the drugs have complained about the lack of research. And now a new study suggests that the drugs do more good than harm.

NPR's Joanne Silberner has more.

JOANNE SILBERNER: Several years ago, some parents blamed antidepressants for the suicides of their depressed children, and studies suggested the drugs might promote suicidal thoughts. So the FDA sent out a warning to doctors. That started a series of hearings and headlines. In 2004, the FDA called for so-called black box warning labels on antidepressants. While this was going on, teenager Michael Haas of Needham, Massachusetts, was struggling. He wasn't eating or sleeping.

Mr. MICHAEL HAAS: I'd sort of cut myself off from, like, my friends and activities I used to like to do. I more or less dropped out of school.

SILBERNER: His pediatrician and then a psychopharmacologist suggested antidepressants. His mother, Ronnie Haas, went along. She tried not to pay attention to the headlines about suicides and suicidal thoughts in teenagers taking antidepressants.

Ms. RONNIE HAAS (Mother of Michael Haas): I was more nervous about not going along with it. I - for us, it just felt a higher risk not to take action.

SILBERNER: Child psychiatrist David Brent sees patients and runs government-funded tests on antidepressants at the University of Pittsburgh. He was getting questions from parents who wanted to know if he was going to make their children worse. And his university asked him to stop doing research.

Dr. DAVID BRENT (Child Psychiatrist): You know, it forced us to think carefully about the risks and benefits of the medications and what ought to be communicated to families and clinicians.

SILBERNER: So Brent and several of his colleagues identified 27 studies of antidepressants in 5,000 younger people with depression, obsessive-compulsive disorder or extreme anxiety. They report their findings in the current issue of the Journal of the American Medical Association.

Dr. BRENT: The medications are effective. And they help many more people than are affected by this slightly increased risk for suicidal ideation and behavior.

SILBERNER: The drugs tended to be more effective in teenagers than in younger children. Even some critics of antidepressant use were impressed. Psychiatrist Lawrence Greenhill of Columbia University:

Dr. LAWRENCE GREENHILL (Psychiatrist, Columbia University): I think it will increase the comfort level of both families and physicians in terms of when they turn to the possibility of taking an antidepressant, knowing that the risks are slightly smaller and the benefits are better defined.

SILBERNER: But will the new studies end the discussions? Probably not, says study author David Brent. The safety of antidepressants in children is a very emotional issue.

Dr. BRENT: You're talking about people who lost their kids to suicide and they were treated with these medications. Even though you might say on a statistical basis, you know, the odds are low and the risk is low, you can't convince somebody that in their kid, that this isn't what happened.

SILBERNER: As for Michael Haas, who's been on antidepressants for over a year...

Mr. HAAS: Instead of being super, super depressed to the point of suicidal or just under that, it sort of just eliminated that. So I never got that far down - or usually didn't.

SILBERNER: He's 18 now and back in school. But he says the depression is not a past-tense thing. He's still on drugs. He's still in psychotherapy.

Joanne Silberner, NPR News.

SIEGEL: And you can find a timeline of actions by the FDA and others regarding the use of antidepressants in children and teens at our Web site,

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