The ethics of paediatric anti-depressant use: erring on the side of caution

Abstract

This paper aims to outline the ethical concerns regarding the use of antidepressant medication in children and adolescents. Recent debates surrounding this issue have focused on the link between selective serotonin reuptake inhibitor use and an increased risk of suicidal thinking/behaviour, and weighed that against the benefit of the alleviation of depressive symptoms. It is argued here that such an approach is simplistic. There are several serious risks surrounding antidepressant use in the young that ought to be included in the equation, along with a consideration of the neuroethical concerns surrounding pharmacotherapy for affective disorders. Using the precautionary principle as a framework for analysis it is concluded that the risks are sufficiently serious and plausible that the prescribing of antidepressant medication to the young ought to be severely restricted; further it is imperative that the child and their parents are made fully aware of the risks, short-term and long-term, involved.

Open-label adjunctive creatine for female adolescents with SSRI-resistant major depressive disorder: A 31-phosphorus magnetic resonance spectroscopy study

“…At a time when ethicists have argued that antidepressant prescription to pediatric patients should be “severely restricted” (Shearer and Bermingham, 2008), interventions with potential to reduce depressive symptoms and suicidality in adolescent MDD are urgently required. Long studied as an ergogenic supplement for athletic skeletal muscle performance, it is now clear that creatine plays a vital role in brain function (Brosnan and Brosnan, 2007).…”

Environmental Enrichment Rescues Postnatal Neurogenesis Defect in the Male and Female Ts65Dn Mouse Model of Down Syndrome

“…Recently, Bianchi et al [18] reported that fluoxetine treatment in Ts65Dn mice improves cognitive ability. Although these medications are commonly prescribed, studies have shown that fluoxetine can increase the risk of suicidal thinking/behavior [19] and that lithium can be toxic to the renal system [20]. Therefore, the potential risk of these treatments on patients with DS may outweigh the clinical benefit.…”