Antidepressants cause mood elevation and behavioral activation in children and adolescents

A paper published in the current issue of P&P by a group of researchers of the University of Bologna (headed by Professor Giovanni Fava) and a Harvard psychopharmacologist (professor Ross Baldessarini) has analyzed data that derive from randomized controlled trials concerned with the use of antidepressant drugs in children and adolescents. The results are shocking: in at least one patient out of 10 antidepressants cause mood elevation and behavioral activation that may persist long after drug administration and create a permanent state of mood instability.

Authors compared reports of antidepressant trials (n =6,767 subjects) in juvenile depressive (n = 17) and anxiety disorders (n = 25) for consensus-based indications of psychopathological mood elevation or behavioral activation. Rates of excessive arousal-activation during treatment with antidepressants were at least as high in juvenile anxiety (13.8%) as depressive (9.79%) disorders, and much lower with placebos. Risks of excessive mood elevation during antidepressant treatment, including mania-hypomania, were much greater than with placebo, and similar in juvenile anxiety and depressive disorders. Excessive arousal-activation in children or adolescents treated with antidepressants for anxiety as well as depressive disorders calls for particular caution and monitoring for potential risk of future bipolar disorder.