Healthy Skepticism Library item: 11720

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Publication type: Journal Article

Cotgrove A.
Head to head: Should young people be given antidepressants? Yes
BMJ 2007 Oct 13; 335:(7623):750
http://www.bmj.com/cgi/content/short/335/7623/750?etoc

Abstract:

Depression is disabling a growing proportion of children, but evidence on treatment is disputed. Andrew Cotgrove believes drugs are a vital part of the armoury but Sami Timimi is unconvinced that they are helpful or safe

Depression and obsessive-compulsive disorder cause considerable distress in young people. These disorders affect emotional, educational, and social development. To deny these vulnerable groups the possibility of receiving antidepressants would be to withhold one of the few evidence based treatments available to them.

There are genuine reasons to question their use. Firstly, much of the evidence has, quite rightly, been strongly criticised in recent years. Secondly, the drugs are associated with appreciable risks, in particular an increase in suicidality. Thirdly, other treatments are available. Nevertheless, the evidence indicates that the benefits of these drugs outweigh the risks when used in the appropriate clinical context. I shall focus on the use of selective serotonin reuptake inhibitors (SSRIs) because this is the group of antidepressants for which the evidence in young people is strongest1 and it is the use of these drugs in depression that has been most controversial.

Quality of evidence
The criticisms of research . . .

Risks and benefits

Evidence for other treatments

Obsessive-compulsive disorder

Informed choice

andy.cotgrove@cwpnt.nhs.uk