Antidepressants found ineffective on teenagers Canadian Press

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Antidepressants found ineffective on teenagers

By ROD MICKLEBURGH

Tuesday, February 17, 2004 - Page A1

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VANCOUVER -- Widely used antidepressant drugs prescribed to tens of thousands of

Canadian teens and children are barely more effective than placebos in treating

adolescent depression, according to a leading Canadian expert in the field.

The assertion by psychiatrist Jane Garland follows a recent cascade of critical

information questioning the risk and effectiveness of prescribing antidepressant

medication for troubled young patients.

" The disappointing reality is that antidepressant medications have minimal to no

effectiveness in childhood depression beyond a placebo effect, " Dr. Garland said

in a commentary in today's Canadian Medical Association Journal.

Dr. Garland, head of the Mood and Anxiety Disorders Clinic at Children's

Hospital here, said the lack of evidence showing significant benefits from

adolescent use of the drugs is stunning, given the huge increase in such

prescriptions over the past few years.

Seven drugs known as SSRIs (selective serotonin reuptake inhibitors) are under

fire, one of them the well-known Prozac. Although no national figures for

adolescent use are available, in British Columbia, an estimated 6,200 children

and teens were prescribed SSRIs in 2002, more than double the number four years

earlier. All told, nearly 14 million SSRI prescriptions were written for

Canadians of all ages in 2002 and cost $869-million.

Drug manufacturers have come under increasing attack for withholding trial

results indicating slight increases in suicidal behaviour, adverse side effects

and only minimal effectiveness of SSRIs in children and teenagers.

Several drug tests that came to light last year prompted British authorities in

effect to ban prescription of all SSRIs except Prozac to patients under 18.

Two weeks ago, Health Canada issued an advisory to anyone under 18 taking one of

seven antidepressants to consult with their doctors " to confirm that the

benefits still outweigh the potential risk. "

In her commentary, Dr. Garland called the situation a crisis in the treatment of

childhood depression, which she said affects one in five Canadians at least

once.

She criticized " opinion leaders in child psychiatry " for remaining silent in the

face of escalating data on the relative ineffectiveness of SSRIs. " It is

disturbing. "

Dr. Garland cited one study showing that 69 per cent of clinically depressed

young patients improved taking the SSRI drug Zoloft, compared with 59 per cent

who improved taking a placebo.

" Essentially, only one in 10 patients receiving [Zoloft] improved, a result

described in the report as 'statistically and clinically significant' when it is

almost certainly clinically meaningless. "

She said some trial results indicate SSRIs may help adolescents with anxiety

disorders or particularly severe depression that has resisted other forms of

treatment.

" But those with milder, garden-variety depression may be no better off than with

a placebo, " Dr. Garland said yesterday in an interview.

She said physicians should inform young patients and their parents that

medication will not cure depression, although it might improve some symptoms.

And they should also be told that psychiatric or behavioural adverse effects are

at least as likely as antidepressant effects, Dr. Garland said.

No SSRI has been approved by Health Canada for patients under 18, although the

so-called " off-label " use of medications is common in many areas of treatment.

At Children's Hospital, in light of new doubts about antidepressants,

psychiatrists are recommending only two for new patient prescriptions: Prozac

for depression, and Zoloft for obsessive-compulsive disorder.

Dr. Marshall Korenblum, chief psychiatrist at the Hincks-Dellcrest Centre for

Children in Toronto, is concerned but unconvinced by recent disclosures

questioning the adolescent use of SSRIs.

" We've had 10 years of experience with some of these drugs, and we didn't hear

about them in such negative terms before. "

Dr. Korenblum said he has had good results prescribing SSRIs to his young

patients. " A reduction in anxiety. A lifting of depression. Normalization of

sleep and eating habits. "

But he agreed more patient monitoring is needed because of the new data. " Some

of the negative tests are alarming and disturbing. . . . I am in favour of

closer monitoring and stiffer warnings. But the evidence is not strong enough

for an outright ban. "

Jim - Norman

" Never look at the trombones, it only encourages them. "

Strauss

[Guest guest]

Antidepressants found ineffective on teenagers

By ROD MICKLEBURGH

Tuesday, February 17, 2004 - Page A1

E-mail this Article

Print this Article

Advertisement

VANCOUVER -- Widely used antidepressant drugs prescribed to tens of thousands of

Canadian teens and children are barely more effective than placebos in treating

adolescent depression, according to a leading Canadian expert in the field.

The assertion by psychiatrist Jane Garland follows a recent cascade of critical

information questioning the risk and effectiveness of prescribing antidepressant

medication for troubled young patients.

" The disappointing reality is that antidepressant medications have minimal to no

effectiveness in childhood depression beyond a placebo effect, " Dr. Garland said

in a commentary in today's Canadian Medical Association Journal.

Dr. Garland, head of the Mood and Anxiety Disorders Clinic at Children's

Hospital here, said the lack of evidence showing significant benefits from

adolescent use of the drugs is stunning, given the huge increase in such

prescriptions over the past few years.

Seven drugs known as SSRIs (selective serotonin reuptake inhibitors) are under

fire, one of them the well-known Prozac. Although no national figures for

adolescent use are available, in British Columbia, an estimated 6,200 children

and teens were prescribed SSRIs in 2002, more than double the number four years

earlier. All told, nearly 14 million SSRI prescriptions were written for

Canadians of all ages in 2002 and cost $869-million.

Drug manufacturers have come under increasing attack for withholding trial

results indicating slight increases in suicidal behaviour, adverse side effects

and only minimal effectiveness of SSRIs in children and teenagers.

Several drug tests that came to light last year prompted British authorities in

effect to ban prescription of all SSRIs except Prozac to patients under 18.

Two weeks ago, Health Canada issued an advisory to anyone under 18 taking one of

seven antidepressants to consult with their doctors " to confirm that the

benefits still outweigh the potential risk. "

In her commentary, Dr. Garland called the situation a crisis in the treatment of

childhood depression, which she said affects one in five Canadians at least

once.

She criticized " opinion leaders in child psychiatry " for remaining silent in the

face of escalating data on the relative ineffectiveness of SSRIs. " It is

disturbing. "

Dr. Garland cited one study showing that 69 per cent of clinically depressed

young patients improved taking the SSRI drug Zoloft, compared with 59 per cent

who improved taking a placebo.

" Essentially, only one in 10 patients receiving [Zoloft] improved, a result

described in the report as 'statistically and clinically significant' when it is

almost certainly clinically meaningless. "

She said some trial results indicate SSRIs may help adolescents with anxiety

disorders or particularly severe depression that has resisted other forms of

treatment.

" But those with milder, garden-variety depression may be no better off than with

a placebo, " Dr. Garland said yesterday in an interview.

She said physicians should inform young patients and their parents that

medication will not cure depression, although it might improve some symptoms.

And they should also be told that psychiatric or behavioural adverse effects are

at least as likely as antidepressant effects, Dr. Garland said.

No SSRI has been approved by Health Canada for patients under 18, although the

so-called " off-label " use of medications is common in many areas of treatment.

At Children's Hospital, in light of new doubts about antidepressants,

psychiatrists are recommending only two for new patient prescriptions: Prozac

for depression, and Zoloft for obsessive-compulsive disorder.

Dr. Marshall Korenblum, chief psychiatrist at the Hincks-Dellcrest Centre for

Children in Toronto, is concerned but unconvinced by recent disclosures

questioning the adolescent use of SSRIs.

" We've had 10 years of experience with some of these drugs, and we didn't hear

about them in such negative terms before. "

Dr. Korenblum said he has had good results prescribing SSRIs to his young

patients. " A reduction in anxiety. A lifting of depression. Normalization of

sleep and eating habits. "

But he agreed more patient monitoring is needed because of the new data. " Some

of the negative tests are alarming and disturbing. . . . I am in favour of

closer monitoring and stiffer warnings. But the evidence is not strong enough

for an outright ban. "

Jim - Norman

" Never look at the trombones, it only encourages them. "

Strauss

[Guest guest]

Antidepressants found ineffective on teenagers

By ROD MICKLEBURGH

Tuesday, February 17, 2004 - Page A1

E-mail this Article

Print this Article

Advertisement

VANCOUVER -- Widely used antidepressant drugs prescribed to tens of thousands of

Canadian teens and children are barely more effective than placebos in treating

adolescent depression, according to a leading Canadian expert in the field.

The assertion by psychiatrist Jane Garland follows a recent cascade of critical

information questioning the risk and effectiveness of prescribing antidepressant

medication for troubled young patients.

" The disappointing reality is that antidepressant medications have minimal to no

effectiveness in childhood depression beyond a placebo effect, " Dr. Garland said

in a commentary in today's Canadian Medical Association Journal.

Dr. Garland, head of the Mood and Anxiety Disorders Clinic at Children's

Hospital here, said the lack of evidence showing significant benefits from

adolescent use of the drugs is stunning, given the huge increase in such

prescriptions over the past few years.

Seven drugs known as SSRIs (selective serotonin reuptake inhibitors) are under

fire, one of them the well-known Prozac. Although no national figures for

adolescent use are available, in British Columbia, an estimated 6,200 children

and teens were prescribed SSRIs in 2002, more than double the number four years

earlier. All told, nearly 14 million SSRI prescriptions were written for

Canadians of all ages in 2002 and cost $869-million.

Drug manufacturers have come under increasing attack for withholding trial

results indicating slight increases in suicidal behaviour, adverse side effects

and only minimal effectiveness of SSRIs in children and teenagers.

Several drug tests that came to light last year prompted British authorities in

effect to ban prescription of all SSRIs except Prozac to patients under 18.

Two weeks ago, Health Canada issued an advisory to anyone under 18 taking one of

seven antidepressants to consult with their doctors " to confirm that the

benefits still outweigh the potential risk. "

In her commentary, Dr. Garland called the situation a crisis in the treatment of

childhood depression, which she said affects one in five Canadians at least

once.

She criticized " opinion leaders in child psychiatry " for remaining silent in the

face of escalating data on the relative ineffectiveness of SSRIs. " It is

disturbing. "

Dr. Garland cited one study showing that 69 per cent of clinically depressed

young patients improved taking the SSRI drug Zoloft, compared with 59 per cent

who improved taking a placebo.

" Essentially, only one in 10 patients receiving [Zoloft] improved, a result

described in the report as 'statistically and clinically significant' when it is

almost certainly clinically meaningless. "

She said some trial results indicate SSRIs may help adolescents with anxiety

disorders or particularly severe depression that has resisted other forms of

treatment.

" But those with milder, garden-variety depression may be no better off than with

a placebo, " Dr. Garland said yesterday in an interview.

She said physicians should inform young patients and their parents that

medication will not cure depression, although it might improve some symptoms.

And they should also be told that psychiatric or behavioural adverse effects are

at least as likely as antidepressant effects, Dr. Garland said.

No SSRI has been approved by Health Canada for patients under 18, although the

so-called " off-label " use of medications is common in many areas of treatment.

At Children's Hospital, in light of new doubts about antidepressants,

psychiatrists are recommending only two for new patient prescriptions: Prozac

for depression, and Zoloft for obsessive-compulsive disorder.

Dr. Marshall Korenblum, chief psychiatrist at the Hincks-Dellcrest Centre for

Children in Toronto, is concerned but unconvinced by recent disclosures

questioning the adolescent use of SSRIs.

" We've had 10 years of experience with some of these drugs, and we didn't hear

about them in such negative terms before. "

Dr. Korenblum said he has had good results prescribing SSRIs to his young

patients. " A reduction in anxiety. A lifting of depression. Normalization of

sleep and eating habits. "

But he agreed more patient monitoring is needed because of the new data. " Some

of the negative tests are alarming and disturbing. . . . I am in favour of

closer monitoring and stiffer warnings. But the evidence is not strong enough

for an outright ban. "

Jim - Norman

" Never look at the trombones, it only encourages them. "

Strauss

[Guest guest]

Antidepressants found ineffective on teenagers

By ROD MICKLEBURGH

Tuesday, February 17, 2004 - Page A1

E-mail this Article

Print this Article

Advertisement

VANCOUVER -- Widely used antidepressant drugs prescribed to tens of thousands of

Canadian teens and children are barely more effective than placebos in treating

adolescent depression, according to a leading Canadian expert in the field.

The assertion by psychiatrist Jane Garland follows a recent cascade of critical

information questioning the risk and effectiveness of prescribing antidepressant

medication for troubled young patients.

" The disappointing reality is that antidepressant medications have minimal to no

effectiveness in childhood depression beyond a placebo effect, " Dr. Garland said

in a commentary in today's Canadian Medical Association Journal.

Dr. Garland, head of the Mood and Anxiety Disorders Clinic at Children's

Hospital here, said the lack of evidence showing significant benefits from

adolescent use of the drugs is stunning, given the huge increase in such

prescriptions over the past few years.

Seven drugs known as SSRIs (selective serotonin reuptake inhibitors) are under

fire, one of them the well-known Prozac. Although no national figures for

adolescent use are available, in British Columbia, an estimated 6,200 children

and teens were prescribed SSRIs in 2002, more than double the number four years

earlier. All told, nearly 14 million SSRI prescriptions were written for

Canadians of all ages in 2002 and cost $869-million.

Drug manufacturers have come under increasing attack for withholding trial

results indicating slight increases in suicidal behaviour, adverse side effects

and only minimal effectiveness of SSRIs in children and teenagers.

Several drug tests that came to light last year prompted British authorities in

effect to ban prescription of all SSRIs except Prozac to patients under 18.

Two weeks ago, Health Canada issued an advisory to anyone under 18 taking one of

seven antidepressants to consult with their doctors " to confirm that the

benefits still outweigh the potential risk. "

In her commentary, Dr. Garland called the situation a crisis in the treatment of

childhood depression, which she said affects one in five Canadians at least

once.

She criticized " opinion leaders in child psychiatry " for remaining silent in the

face of escalating data on the relative ineffectiveness of SSRIs. " It is

disturbing. "

Dr. Garland cited one study showing that 69 per cent of clinically depressed

young patients improved taking the SSRI drug Zoloft, compared with 59 per cent

who improved taking a placebo.

" Essentially, only one in 10 patients receiving [Zoloft] improved, a result

described in the report as 'statistically and clinically significant' when it is

almost certainly clinically meaningless. "

She said some trial results indicate SSRIs may help adolescents with anxiety

disorders or particularly severe depression that has resisted other forms of

treatment.

" But those with milder, garden-variety depression may be no better off than with

a placebo, " Dr. Garland said yesterday in an interview.

She said physicians should inform young patients and their parents that

medication will not cure depression, although it might improve some symptoms.

And they should also be told that psychiatric or behavioural adverse effects are

at least as likely as antidepressant effects, Dr. Garland said.

No SSRI has been approved by Health Canada for patients under 18, although the

so-called " off-label " use of medications is common in many areas of treatment.

At Children's Hospital, in light of new doubts about antidepressants,

psychiatrists are recommending only two for new patient prescriptions: Prozac

for depression, and Zoloft for obsessive-compulsive disorder.

Dr. Marshall Korenblum, chief psychiatrist at the Hincks-Dellcrest Centre for

Children in Toronto, is concerned but unconvinced by recent disclosures

questioning the adolescent use of SSRIs.

" We've had 10 years of experience with some of these drugs, and we didn't hear

about them in such negative terms before. "

Dr. Korenblum said he has had good results prescribing SSRIs to his young

patients. " A reduction in anxiety. A lifting of depression. Normalization of

sleep and eating habits. "

But he agreed more patient monitoring is needed because of the new data. " Some

of the negative tests are alarming and disturbing. . . . I am in favour of

closer monitoring and stiffer warnings. But the evidence is not strong enough

for an outright ban. "

Jim - Norman

" Never look at the trombones, it only encourages them. "

Strauss