Study: Most antidepressants don't work for young patients

LONDON -- Scientists say most antidepressants don't work for children or teenagers with major depression, some may be unsafe and the quality of evidence about these drugs is so bad, the researchers cannot be sure whether any are truly effective or safe.

In the biggest analysis conducted of previously published studies, researchers studied 14 antidepressants and found only one drug that seemed to be useful.

"We now have a hierarchy of pharmaceutical treatments, and the only one that is better than placebo and other drugs is Prozac," said Dr. Andrea Cipriani of the University of Oxford, one of the study authors. He said psychological treatment such as behavioral therapy should be tried before prescribing drugs, echoing the recommendations of some current guidelines.

Cipriani and colleagues analyzed 34 drug trials that included more than 5,000 patients. Of those, 22 studies were paid for by pharmaceutical companies.

The scientists called the quality of the evidence in the research they studied "very low" -- so low they said their findings weren't enough to change how patients are treated. The authors cautioned their results were based on flawed trials, and they couldn't figure out whether the drugs were effective or gauge the effect of serious side effects.

Still, the review was enough to call into question the vast majority of medications used to treat young people with depression.

Among findings on individual drugs, the researchers found Sensoval was less effective than seven other antidepressants and a placebo and that Tofranil, Effexor and Cymbalta led to the worst side effects. When compared to five other drugs and a placebo, Effexor was linked to a risk of increased suicide attempts and suicidal thoughts.

The new study was published online Wednesday in the journal Lancet.