Researchers in this week's BMJ uncover disturbing shortcomings in trials of newer antidepressants in this patient group. They conclude that antidepressant drugs cannot confidently be recommended as a treatment option for childhood depression.
They reviewed six published trials of newer antidepressants in children. They analysed each study's methods and the extent to which authors' conclusions were supported by data.
Drug companies paid for the trials and otherwise remunerated the authors of at least three of the four larger studies.
The trials consistently exaggerated the benefits of drugs and downplayed the side effects. Improvement in control groups was strong, while additional benefit from drugs was of doubtful clinical significance, write the authors.
Biased reporting and over-confident recommendations in treatment guidelines may mislead doctors, patients, and families, they say. Many will undervalue non-drug treatments that are probably both safer and more effective.
Trustworthy trial results are a foundation of good medical care. It is vital that authors, reviewers, and editors ensure that published interpretations of data are more reasonable and balanced than is the case in the industry dominated literature on childhood antidepressants, they conclude.