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Antidepressants increase risk of behavioural symptoms in children and adolescents with depression or anxiety

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Question: In children and adolescents with mood or anxiety disorders, is antidepressant use associated with symptoms of excessive emotional arousal or behavioural activation?

Outcomes: Observed symptoms of excessive emotional arousal or behavioural activation, in addition to mania-hypomania (details of scales and methods not provided).


Design: Systematic review with meta-analysis.

Data sources: MEDLINE, PsycINFO, CINAHL, PubMed, Cochrane Library and Web of Science were searched from inception to March 2012, supplemented by hand search of reference lists.

Study selection and analysis: Randomised controlled trials (RCTs), retrospective studies, reviews and meta-analyses of antidepressant use in children or adolescents (aged less than 18 years) with diagnosed depression or anxiety disorders. Studies were reviewed to identify reports of the new-onset behavioural symptoms. Continuous measures were compared using analysis of variance methods or paired t tests and random-effects meta-analysis.

Main results

Forty-two studies (n=6767) met inclusion criteria. Depression: 17 studies (six RCTs) were in children/adolescents (mean age 12.5 years; 54.3% boys) with depression disorders (n=2637; 2083 taking antidepressants and …

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  • Sources of funding Bruce J Anderson Foundation; McClean Private Donors Psychopharmacology Research Fund.