Do not prescribe
anti-depressants to children with mild depression, government urges
by Angela Hussain.
and psychiatrists should not prescribe anti-depressants as a first
line treatment to under 18s with mild depression, a government guideline
released today urges.
guideline states this is because SSRI antidepressants, the most
widely prescribed group of antidepressants, carry a risk of suicidal
18s with continuing mild depression should, instead, be provided
with non-directive supportive therapy, group cognitive behavioural
therapy or self help, says the guideline by the government's National
Institute for Clinical Excellence (NICE)
guideline's recommendations follow an announcement in 2003 by the
drug regulatory body, the Medicines and Healthcare Products Regulatory
Agency, that SSRIs are associated with increased suicide-related
behaviour and hostility in young people. Prozac was exempted.
is estimated that there are 40,000 children taking anti-depressants
for depression, anxiety and other problems.
guideline does state, however, that doctors can prescribe antidepressants
to children with moderate to severe depression, but only if psychological
therapy is also being provided.
the guideline urges professionals to be alert to suicidal behaviour
after a child is prescribed anti-depressants.
states: "A child or young person prescribed an antidepressant
should be closely monitored for the appearance of suicidal behaviour,
self-harm or hostility, particularly at the beginning of treatment,
by the prescribing doctor and the healthcare professional delivering
the psychological therapy."
guideline also recommends that under 18s with moderate to severe
depression should be offered, as a first-line treatment, a psychological
therapy such as cognitive behavioural therapy, interpersonal therapy
or family therapy of at least three months.
Dillon, chief executive of NICE, said:"This guideline makes
it clear that psychological treatments are the most effective way
to treat depression in children and young people."
guideline has been welcomed by mental health groups. But concerns
have been voiced that there is a huge shortage of professionals
to provide psychological therapy.
Morley, deputy director of the charity YoungMinds said: "The
very significant shortage of practitioners able to deliver these
therapies is a cause for concern."
NICE's clinical guideline
on the treatment and management of depression in children and young
June 6, 2005: Euro panel to decide on Prozac for children - arbitration
begins on conflicting opinion on safety of Prozac to treat depression
for under 18s across Europe.
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