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Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review

BMJ open, 2020-07, Vol.10 (7), p.e036412-e036412 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. ;2020 Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;info:eu-repo/semantics/openAccess ;Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020 ;ISSN: 2044-6055 ;EISSN: 2044-6055 ;DOI: 10.1136/bmjopen-2019-036412 ;PMID: 32690742

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  • Title:
    Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review
  • Author: Westergren, Tone ; Narum, Sigrid ; Klemp, Marianne
  • Subjects: Adolescent ; Antidepressive Agents - adverse effects ; Anxiety ; Child ; Child & adolescent psychiatry ; Children & youth ; Classification ; Clinical medicine ; Clinical practice guidelines ; Depression - drug therapy ; Drug therapy ; Humans ; Library collections ; Mental depression ; Mental disorders ; Pharmacology and Therapeutics ; Quality ; Reproductive system ; Sleep disorders ; Suicidal Ideation ; Suicides & suicide attempts ; Systematic review ; Teenagers ; Websites
  • Is Part Of: BMJ open, 2020-07, Vol.10 (7), p.e036412-e036412
  • Description: ObjectivesTo analyse to what extent clinical practice guidelines on drug treatment of depression in children and adolescents mention the risk of adverse effects, to characterise the citations in the guidelines and to assess to what extent data from a major study (Treatment for Adolescents With Depression Study, TADS) was used as basis for information about adverse effects.DesignSystematic review of clinical guidelines and clinical decision support tools.Data sourcesPubMed, EMBASE, guideline collections, Health libraries.Eligibility criteriaWe included national guidelines on depression in children and adolescents from European and/or English-speaking countries, published in English, German, French or any Scandinavian language since 2008. We also included well-known, international clinical decision support tools.Data extraction and synthesisGuidelines were examined by all authors to identify and classify information on adverse effects. Citations for statements on adverse effects were extracted and classified by category. The extent of citations about suicidality risk versus other adverse effects was assessed.Results19 guidelines were assessed. All guidelines discussed risk of suicidal behaviour connected with use of antidepressants. Most guidelines mentioned some other psychiatric adverse effects. Several guidelines did not include information on well-known and common somatic adverse effects. Most references concerned risk of suicidality. Adverse effects identified in underlying studies were not always presented. The TADS study was referred to, directly or indirectly, by 18/19 guidelines, but some only referred to TADS with regard to suicidality without citing the study’s findings of somatic adverse effects. No guideline commented on the lack of long-term adverse effects data from TADS.ConclusionsGuidelines for treatment of depression in children and adolescents vary widely regarding information on adverse effects. Many guidelines do not provide information on common somatic adverse effects. There is no consensus as to what extent risks of adverse effects connected with use of antidepressants should be described in guidelines.
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English;Norwegian
  • Identifier: ISSN: 2044-6055
    EISSN: 2044-6055
    DOI: 10.1136/bmjopen-2019-036412
    PMID: 32690742
  • Source: ProQuest One Psychology
    BMJ Open Access Journals
    GFMER Free Medical Journals
    MEDLINE
    NORA Norwegian Open Research Archives
    PubMed Central
    ROAD: Directory of Open Access Scholarly Resources
    ProQuest Central
    DOAJ Directory of Open Access Journals
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