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Physicians Watch for Increased Suicide Risk in Children on Antidepressants

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U.S. Food and Drug Administration (FDA) concerns about an increased risk of suicide among pediatric patients taking antidepressants are causing increased vigilance among physicians, according to a new NOP World Health event flash.

This greater caution, however, is not necessarily causing a decline in prescribing of SSRI or SNRI antidepressants for children or adolescents.

The majority of physicians believe that the benefits of antidepressants outweigh the risks. This is true across all specialties - particularly psychiatrists. Parents seem to agree with this view and are not pressuring doctors to remove their children from these drugs.

NOP World Health's research was done in the wake of the FDA's ongoing examination into the risks of suicide and "activation" symptoms - such as increased agitation, aggression, confusion and akathisia - among children and teens with major depressive disorders taking SNRIs or SSRIs.

Based on its findings, the FDA may issue new recommendations guiding the prescribing of antidepressants to pediatric patients.

NOP World Health conducted its study in February, via Internet, among 259 physicians who treat pediatric patients with major depression. Participating specialties included family and general practitioners, general and pediatric psychiatrists and pediatricians.

Although the majority of doctors in all specialties anticipate they will keep prescribing antidepressants to their depressed pediatric patients, SSRIs and SSNIs do face some vulnerability among general and family practitioners.

These physicians expect that 15% of their pediatric patients with major depressive disorders will now go without drug therapy - a far higher proportion than any other specialty group.

Child psychiatrists plan to continue writing antidepressants for their pediatric patients but are likely to shift some of their prescribing to Prozac (fluoxetine) - the only agent indicated for children. General psychiatrists will not change their current pediatric prescribing much at all, in response to the FDA's concerns.

"Most doctors will be monitoring their pediatric patients more closely for suicidal ideation," says Andrea McDonough, senior director of market events for NOP World Health. "Only a small minority plan to change the way they treat depressed pediatric patients - and even fewer say that they'll proactively take children and teens off antidepressant drugs."

NOP World Health is a supplier of primary research to the global healthcare community. This article was prepared by Biotech Week editors from staff and other reports. Copyright 2004, Biotech Week via &

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