Most anti-depressants unsuitable for children due to suicide risk

ANTI-depressant drugs which could make young patients suicidal have never been approved for children under 18 years of age, the Irish Medicines Board said yesterday.

|The Board was reacting to the situation in Britain where doctors were told not to prescribe the majority of anti-depressants to children amid suicide fears.

The British Medicines and Healthcare products Regulatory Agency (MHRA) said most SSRIs (selective serotonin reuptake inhibitors) the most common type of antidepressant were not suitable for under-18s.

The medicines watchdog studied evidence from drugs companies concerning the treatments and concluded that the risks outweighed the benefits.

The side effects have been shown to include suicidal feelings, anxiety, insomnia, weight loss and headaches.

The drugs affected by yesterday's advice are: sertraline (Lustral), citalopram (Cipramil), escitalopram (Cipralex) and fluvoxamine (Faverin).

Earlier this year warnings were also given about the risks of paroxetine (Seroxat) and venflaxine (Efexor).

This leaves just fluoxetine (Prozac) which the MHRA said appeared to have "a positive balance of risks and benefits" in treating under-18s.

Yesterday, the Irish Medicines Board confirmed that SSRIs are not and have never been licensed for use in children (under 18 years) in the treatment of Major Depressive Disorder (MDD) in Ireland.

"The IMB is fully aware of the review undertaken by the British expert group and wishes to re-emphasise that SSRIs are not recommended for use in the treatment of MDD in children in Ireland, as the risks of treatment with certain SSRIs are considered to outweigh the benefits of treatment in this condition," said Dr Joan Gilvarry, Director of Human Medicines, IMB.

Although SSRIs are not licensed for children in Ireland, doctors can prescribe them for patients under their care if it is deemed appropriate.

"We strongly recommend that patients taking SSRIs do not suddenly discontinue use of the drug, because of the risk of withdrawal effects. Any changes must take place under medical supervision," she said.

The SSRIs and related antidepressants that are licensed in Ireland for use in adults include citalopram (Cipramil), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Faverin), paroxetine (Seroxat).

"It should be noted that sertraline (Lustral) and fluvoxamine (Faverin) are licensed for the treatment of Obsessive Compulsive Disorder (OCD) in children and adolescents as the balance of risk versus benefit has been shown to be positive in this condition," Dr Gilvarry said.

The research is not considered to have any impact for the use of SSRIs in adult patients.