The benefits of antidepressants outweigh the risks of suicidal attempts in children when the medications are used to treat depression and anxiety disorders, according to a review by researchers from the Center fro Innovation in Pediatric Practice (CIPP) at Columbus Children's Hospital.

The review of 27 trials involving more than 5000 pediatric patients aged 19 or younger found that risk of suicidal thought and or attempts was one percent of children who were treated with antidepressants for pediatric major depressive disorder or MDD, obsessive-compulsive disorder or OCD and non-OCD anxiety disorders or ANX. The suicidal risk associated with antidepressants is lower than what was estimated by FDA, which is 2 percent.

The results were published in the April 18, 2007 issue of the Journal of the American Medical Association (JAMA).

Suicidal attempts in children associated with use of antidepressants are a serious concern to the Food and Drug Administration.   The agency's Psychopharmacologic Drugs and Pediatric Advisory Committees made recommendations in 2004 that the FDA require black-box warning for an increased risk of suicidal thoughts and actions associated with the use of certain antidepressants.

"Although our findings regarding suicidal thoughts and attempts are in the same direction as the Food and Drug Administration (FDA) meta-analysis, we found a much lower overall risk and we added analyses of the potential benefit of these medications," said lead author Jeff Bridge, Ph.D., CIPP principal investigator and assistant professor of pediatrics at The Ohio State University College of Medicine.

"This is good news for parents because it gives them more information for discussions with their family's physician about their child's treatment options."

"Our findings mean that antidepressants should be considered as a first-line treatment option for pediatric depression and anxiety disorders, with the recognition that these medications are more effective for anxiety disorders, including OCD, and modestly effective for MDD," said Bridge.

The study also found that fluoxetine or PROZAC was the only antidepressant that was found effective in treating depression in children younger than 12 years, Bridge said.   For children aged 12 years or older, several antidepressants were effective in treating depression.

The results were derived from a meta-analysis of twenty-seven published and unpublished randomized controlled trial reports that looked at both the benefits and risks of antidepressants in treating children younger than 19 years for MDD, OCD and ANX.