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Read Original Story

Antidepressants’ risks to children slim, study says

Rating

4 Star

Antidepressants’ risks to children slim, study says

Our Review Summary

The story provides the reader with a comparison of anti-depressants' effectiveness and the risk of suicidal thoughts or actions in young children and teenagers. The story describes results of a recently published meta-analysis and explains why the results of this new study may differ from data on which an FDA warning of increased suicidal behavior in children taking anti-depressants was based.  The story provides the number needed to harm as well as other quantitative information on the benefits of anti-depressants for particular mood disorders.

The story focuses on only one potential harm of treatment, i.e. suicide and suicidal ideation. It would have been reasonable to report on other common side effects of these medications (e.g. stomach problems, insomnia, irritability, and mania in some children). While these medications are considered safe – even with the FDA warning – there is little long-term data on their safety in these groups. 

The original version of the story by the Associated Press included several items left out by the Cleveland Plain Dealer when it picked up the story: 

  • an interview with a second, independent expert source;
  • mention of other treatment options such as psychotherapy, especially cognitive behavioral therapy. 

The story interviews one of the lead authors of the study.  However we are not told if he has financial ties with the pharmaceutical makers of anti-depressant medications.  The JAMA article gives conflict of interest info and there are potential conflicts that are not reported in the news story. Other clinical and patient perspectives are needed to provide balance to the story and as a means of discussing this treatment option for children and teenagers.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The cost of anti-depressant medications are not mentioned. Cost of generic prozac is about $16/month.  Branded versions are about $80-120/month

 

 

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story does provide absolute data on the positive benefit of these medication for several mood disorders.  The story also presents the number needed to harm. The story presents an adequate risk to benefit comparison by providing the data. 

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story focuses on only one potential harm of treatment, i.e. suicide and suicidal ideation.  The story does not list the side effects of these medications (stomach problems, insomnia, irritability, and mania in some children). While these medications are considered safe – even with the FDA warning – there is little long-term data on their safety in these groups. 

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story gives an overview of the meta-analysis and explains why the results of this new study may differ from earlier studies on which an FDA warning of increased suicidal behavior in children taking anti-depressants were based.  The story provides the number needed to harm as well as other quantitative information on the benefits and risks of anti-depressants as they relate to improved mood and risk of suicidal thoughts and feelings. 

Does the story commit disease-mongering?

Satisfactory

The story simply reports the results of a review of many studies looking at suicidal behavior in children and adults who were prescribed anti-depressant medications.   The story would be improved by giving information on frequency of the conditions discussed, but there is NO disease mongering

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story interviews one of the lead authors of the study.  However we are not told if he has financial ties with the pharmaceutical makers of anti-depressant medications.  The JAMA article gives conflict of interest info and there are potential conflicts that are not reported in the news story.

Does the story compare the new approach with existing alternatives?

Satisfactory

The version of the story we reviewed was in the Cleveland Plain Dealer.  This version does not provide other treatment options for children and teenagers who have anxiety disorders and/or depression such as psychotherapy, especially cognitive behavioral therapy.  But the original AP story did include an interview with a Duke expert, unconnected with the JAMA study, who commented on cognitive behavioral therapy. 

Does the story establish the availability of the treatment/test/product/procedure?

Not Applicable

The story does not provide information about the availability of anti-depressant medications for young children and teenagers. However, since this story deals with possible risks from these drugs, this criterion seems less important in this story. 

Does the story establish the true novelty of the approach?

Satisfactory

Anti-depressant medication treatment is children is a relatively new phenomenon.  The story does not mention this. However, the focus of the story was to provide a more up-to-date report of the risk of suicidal ideation and behavior in children taking these medications. Data from this recent systemic review suggest the risk is still there, but not as great as previously thought. 

Does the story appear to rely solely or largely on a news release?

Satisfactory

The original AP story had interviews with two experts, one of them not connected with the research.  So it's safe to assume it did not rely solely or largely on a news release. But the Cleveland Plain Dealer, in which we picked up the story, cut out the quotes from this independent source. 

Total Score: 6 of 9 Satisfactory

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