Opinion: Soapbox - A depressing time for children's treatment

Mild depression is treated with cognitive behavioural therapy and the like. For those with more severe depression, selective serotonin reuptake inhibitors (SSRIs) are the only class of antidepressants in routine use, and then normally for adolescents not younger children.

Many medications aren't licensed for use in children, but are still used. Psychiatrists and paediatricians have over the years developed careful peer-review consensus about prescribing, while following the limited available research drug trial evidence. We follow guidelines issued by the National Collaborating Centre for Mental Health, but they only give guidelines on the evidence made available.

The Expert Working Group of the Committee on Safety of Medicines (CSM) has undertaken a review of the safety of SSRIs for use in children. Members were concerned that drug firms were withholding unfavourable data and that adverse events were being under-reported. The CSM said these drugs might be associated with an increased risk of suicidal behaviour and that there can be important withdrawal reactions on stopping treatment.