Although off-label prescribing is a common, and usually safe, practice when there aren't other treatment options, recent reports of a possible link to an increased risk of suicide for kids taking antidepressants has led some experts to question whether they should be used at all.
These concerns recently led the FDA to warn that children should not be prescribed Paxil, which is commonly used to treat adults with ADHD. And last year, the Committee on Safety of Medicines in Great Britain made the decision that all SSRI medications, besides Prozac, should not be prescribed for new children diagnosed with depression and that they are contraindicated for children under age 18.
There is currently no such general ban in the United States, but should there be? Banning these medications might be an easy answer, but it is important to remember that untreated depression is itself a risk factor for suicide, which is the 3rd leading cause of death for 14 to 25 year olds and the 6th leading cause of death for younger school age children.
Fortunately, the FDA has recently had a series of meeting to address this issue. In addition to health professionals, parents both positively and negatively affected by their kids taking antidepressants, were allowed to testify. The meeting specifically looked at the risk of suicide in kids taking Prozac, Zoloft, Celexa, Paxil CR, Effexor, Remeron, and Serzone.
Although we likely won't hear any formal recommendations from this meeting for a while, the FDA has already stated that antidepressants should be used with 'caution', that they should not be stopped without talking to your doctor first, and that high risk patients should be closely supervised.
You should especially watch for the development of akathisia, in which kids taking antidepressants can become anxious and agitated, and if your child has thoughts of suicide.
