Metastudy antidepressants barely better than placebo in children

Placebo effect and antidepressants in children and adolescents: antidepressants barely better
Children mainly suffer from anxiety disorders, depressive moods, obsessive-compulsive disorder or post-traumatic stress disorder. Although the clinical efficacy of antidepressants in children and adolescents has been proven, it is presumptively prescribed in practice because the side effects are severe. In addition, the placebo effect on the effect on the drugs is unclear. Researchers at the University of Basel have now investigated how high the effect is compared to placebos. A meta-analysis of the data of more than 6500 patients shows: Although antidepressants work better in comparison to placebo, the difference is small and varies according to the type of mental disorder. The journal "JAMA Psychiatry" has published the results of the University of Basel and the Harvard Medical School.

The most common mental disorders in children and adolescents include anxiety disorders, depressive disorders, obsessive-compulsive disorder and post-traumatic stress disorder. In addition to psychotherapeutic interventions, children and adolescents will also receive newer antidepressants such as Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) for treatment..

Antidepressants usually have strong side effects. (Image: pingpao / fotolia.com)

Antidepressants work better than placebo, but have more side effects
Psychologists from the University of Basel have analyzed 36 drug trials with colleagues from Harvard Medical School and the US National Institute of Mental Health. The studies included data from 6778 children and adolescents up to 18 years of age.

The results of the meta-analysis show on the one hand that compared to placebo, antidepressants work significantly better over the different disorders, but the difference is small and varies according to the type of mental disorder. On the other hand, it has been shown that the placebo effect plays an essential role in the action of antidepressants. The study also found that patients treated with antidepressants complained of more side effects than those receiving placebo. Side effects ranged from mild symptoms such as headache to suicidal acts.

Placebo effect stronger in depression
According to the study, the effects of antidepressants and placebo differ depending on the type of mental disorder: Antidepressants have a greater specific effect on anxiety disorders than depressive disorders. On the other hand, placebo acts more in depressive patients than in those with an anxiety disorder. The first authors Dr. Cosima Locher and Helen Koechlin of the Clinical Psychology and Psychotherapy Department of the Faculty of Psychology at the University of Basel see potential for new treatment concepts that specifically target the effect of the factors that contribute to the placebo effect in depression.

Individual clarification necessary
However, the meta-analysis also shows that antidepressants play an important role in the treatment of mental disorders in childhood and adolescence. "It is important to individually clarify the relationship between clinical benefit and possible side effects when talking with the attending physician," says Locher.