Suicidality associated with the use of antidepressants in children and adolescents

Author(s):  
Marta Gutiérrez-Valencia ◽  
◽  
Leire Leache ◽  
Luis Carlos Saiz

INTRODUCCIÓN El suicidio es un problema de salud pública en población infantil y adolescente, siendo una de las principales causas de mortalidad en este rango de edad. A partir de los años 1990, con la introducción de nuevas clases de antidepresivos, comenzó a extenderse la preocupación sobre el riesgo de tendencias suicidas asociado al consumo de estos fármacos en niños y adolescentes. Desde entonces se han realizado numerosos estudios al respecto y distintas agencias reguladoras han alertado sobre este posible aumento del riesgo. Sin embargo, el consumo de antidepresivos en esta población sigue aumentando. OBJETIVO Analizar la evidencia existente sobre la relación entre el uso de antidepresivos en niños y adolescentes y el riesgo de tendencias suicidas. Así mismo, determinar la relación entre este uso y la aparición de eventos adversos graves, así como el abandono del tratamiento por eventos adversos. MÉTODOS Se llevó a cabo una búsqueda bibliográfica en MedLine y The Cochrane Library. Se priorizaron revisiones y, en caso necesario, se amplió la búsqueda a ensayos clínicos aleatorizados. Se consideraron estudios que analizaban el tratamiento con cualquier antidepresivo independientemente del diagnóstico, comparado con placebo, cualquier tratamiento no farmacológico, o no tratamiento. Adicionalmente, se identificaron informes de posicionamiento de sociedades científicas e instituciones sanitarias. Se utilizó la base de datos de dispensación de recetas del Servicio Navarro de Salud-Osasunbidea (SNS-O) para obtener datos acerca del consumo de antidepresivos en Navarra en niños y adolescentes, y la base de datos BIFAP (www.bifap.org) para obtener datos de prevalencia de uso de antidepresivos en Navarra y España. CONCLUSIONES La evidencia actual indica que los antidepresivos aumentan el riesgo de tendencias suicidas en niños y adolescentes, por lo que debería limitarse su uso en esta población y emplearse únicamente en las indicaciones autorizadas. Este riesgo se debe especialmente al aumento de ideación suicida. La evidencia indirecta muestra que el riesgo de tendencias suicidas sería superior con venlafaxina. No existe evidencia suficiente de que ningún fármaco reduzca el riesgo de que se produzcan. Existe amplia evidencia de que los antidepresivos aumentan el riesgo de eventos adversos graves y abandonos por eventos adversos en cualquier indicación en comparación con placebo. En los estudios disponibles se analiza la seguridad cuando se inicia el tratamiento y son en general estudios de corta duración, pero no puede descartarse el riesgo de este tipo de eventos adversos a más largo plazo.

2011 ◽  
Vol 6 (4) ◽  
pp. 1027-1043 ◽  
Author(s):  
Michelle Foisy ◽  
Samina Ali ◽  
Rose Geist ◽  
Michael Weinstein ◽  
Sonia Michail ◽  
...  

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3668
Author(s):  
Tu-Hsuan Chang ◽  
Yu-Chin Chen ◽  
Wei-Yu Chen ◽  
Chun-Yu Chen ◽  
Wei-Yun Hsu ◽  
...  

Background: Lockdown is an effective nonpharmaceutical intervention to reduce coronavirus disease 2019 (COVID-19) transmission, but it restricts daily activity. We aimed to investigate the impact of lockdown on pediatric body weight and body mass index (BMI). Methods: The systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Four online databases (EMBASE, Medline, the Cochrane Library and CINAHL) were searched. Results: The pooled results showed that lockdown was associated with significant body weight gain (MD 2.67, 95% CI 2.12–3.23; p < 0.00001). The BMI of children with comorbidities or obesity did not change significantly. The BMI of general population was significantly higher during lockdown than before the pandemic (MD 0.94, 95% CI 0.32–1.56; p = 0.003). However, heterogeneity was high (I2 = 84%). Among changes in weight classification, increases in the rates of obesity (OR 1.23, 95% CI 1.10–1.37; p = 0.0002) and overweight (OR 1.17, 95% CI 1.06–1.29; p = 0.001) were reported. Conclusions: Our meta-analysis showed significant increases in body weight and BMI during lockdown among school-age children and adolescents. The prevalence of obesity and overweight also increased. The COVID-19 pandemic worsened the burden of childhood obesity.


2016 ◽  
Vol 25 (4) ◽  
Author(s):  
Lara Adrianne Garcia Paiano da Silva ◽  
Fátima Denise Padilha Baran ◽  
Nen Nalú Alves das Mercês

ABSTRACT Integrative review which goal was to identify the scientific production published about the use of music in the care in health of children and adolescents with cancer from 2004 to 2014. The search was conducted in SciELO, LILACS, BDENF, MEDLINE, PubMed and The Cochrane Library databases. Seven studies were selected, which showed positive effects in the use of the music such as decrease of pain, anxiety, depression and showed that the music can bring benefits to the patient and their families. Two categories were defined on the use and effects of music and the patients' perspective, parents and professionals about this practice were elaborated. It was concluded that the use of music as a complementary therapy can improve child and adolescent's physical and mental well-being in face of serious illness and its treatment, and helps to strengthen the bond between the patient and his family, as well as the health care team.


Author(s):  
Wanda M. Williams ◽  
Cynthia G. Ayres

Children and adolescents are not meeting the required federal physical activity (PA) guidelines established by the United States Department of Health and Human Services. It is critical that a regular pattern of PA is established in their youth to ensure ongoing PA into adulthood. However, many programs implemented during adolescence have shown limited effects, stressing the need for more innovative approaches to generate more interest and maintenance of PA behavior in this age group. Active video games (AVGs) or exergaming may prove to be an innovate process to improve PA in children and adolescents. A literature review was conducted to explore if active video games or exergaming could be an effective intervention to improve physical activity in adolescents. Active video games, also called “exergames”, are a category of video games that require movement or physical exertion to play the game. The methodology consisted of searching Academic Search Premier, CINAHL, The Cochrane Library, ERIC, PubMed, and Web of Science databases. Inclusion criteria involved only youth aged 12 to 19 years, randomized controlled trials (RCTs), and studies within the last 12 years. The following search terms were used: exergaming or active video games; physical activity or exercise; adolescents or youth; RCT or randomized clinical trial. The outcome indicates that exergaming or active video games can be an effective tool to improve PA in adolescents that will be more acceptable and sustainable than many conventional approaches.


2018 ◽  
Vol 54 ◽  
pp. 85-97 ◽  
Author(s):  
A. Amerio ◽  
P. Ossola ◽  
F. Scagnelli ◽  
A. Odone ◽  
M. Allinovi ◽  
...  

AbstractIntroduction:Many clinicians are reluctant to use traditional mood-stabilizing agents, especially lithium, in children and adolescents. This review examined the evidence for lithium’s safety and efficacy in this population.Methods:A systematic review was conducted on the use of lithium in children and adolescents with bipolar disorder (BD). Relevant papers published through June 30th 2018 were identified searching the electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Library.Results:30 articles met inclusion criteria, including 12 randomized controlled trials (RCTs). Findings from RCTs demonstrate efficacy for acute mania in up to 50% of patients, and evidence of long-term maintenance efficacy. Lithium was generally safe, at least in the short term, with most common side effects being gastrointestinal, polyuria, or headache. Only a minority of patients experienced hypothyroidism. No cases of acute kidney injury or chronic kidney disease were reported.Conclusions:Though the available literature is mostly short-term, there is evidence that lithium monotherapy is reasonably safe and effective in children and adolescents, specifically for acute mania and for prevention of mood episodes.


VASA ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Jakob Martin Burgstaller ◽  
Johann Steurer ◽  
Ulrike Held ◽  
Beatrice Amann-Vesti

Abstract. Background: Here, we update an earlier systematic review on the preventive efficacy of active compression stockings in patients with diagnosed proximal deep venous thrombosis (DVT) by including the results of recently published trials. The aims are to synthesize the results of the original studies, and to identify details to explain heterogeneous results. Methods: We searched the Cochrane Library, PubMed, Scopus, and Medline for original studies that compared the preventive efficacy of active compression stockings with placebo or no compression stockings in patients with diagnosed proximal DVT. Only randomized controlled trials (RCTs) were included. Results: Five eligible RCTs with a total of 1393 patients (sample sizes ranged from 47 to 803 patients) were included. In three RCTs, patients started to wear compression stockings, placebo stockings or no stockings within the first three weeks after the diagnosis of DVT. The results of two RCTs indicate a statistically significant reduction in post-thrombotic syndrome (PTS) of 50% or more after two or more years. The result of one RCT shows no preventive effect of compression stockings at all. Due to the heterogeneity of the study results, we refrained from pooling the results of the RCTs. In a further RCT, randomization to groups with and without compression stockings took place six months after the diagnosis of DVT, and in another RCT, only patients with the absence of PTS one year after the diagnosis of DVT were analyzed. One RCT revealed a significant reduction in symptoms, whereas another RCT failed to show any benefit of using compression stockings. Conclusions: At this time, it does not seem to be justifiable to entirely abandon the recommendations regarding compression stockings to prevent PTS in patients with DVT. There is evidence favoring compression stockings, but there is also evidence showing no benefit of compression stockings.


2019 ◽  
Vol 2 (2) ◽  
pp. 135-154
Author(s):  
Katja Koelkebeck ◽  
Maja Pantovic Stefanovic ◽  
Dorota Frydecka ◽  
Claudia Palumbo ◽  
Olivier Andlauer ◽  
...  

AbstractObjectivesTo understand and identify factors that promote and prevent research participation among early career psychiatrists (ECPs), in order to understand what would encourage more ECPs to pursue a research career.MethodsWe conducted an electronic search of databases (PubMed and the Cochrane library) using the keywords ‘doctors’, ‘trainees’, ‘residents’, ‘physicians’ and ‘psychiatric trainees’ as well as ‘research’ (MeSH) and ‘publishing’ (MeSH). This search was complemented by a secondary hand search.ResultsWe identified 524 articles, of which 16 fulfilled inclusion criteria for this review. The main barriers included lack of dedicated time for research, lack of mentoring and lack of funding. The main facilitators were opportunities to receive mentorship and access to research funding.ConclusionsAction is needed to counteract the lack of ECPs interested in a career in research. Specific programs encouraging ECPs to pursue research careers and having access to mentors could help increase the current numbers of researching clinicians in the field.


2017 ◽  
Vol 42 (2) ◽  
pp. 149-161
Author(s):  
Henry Cuevas Casa ◽  
Gabriela Aguinaga Romero ◽  
Fabricio González-Andrade

Objetivos: se propone identificar y revisar aquellas estrategias potenciales que incluyan un enfoque multifacético a la hora de hacer frente a la obesidad en niños escolarizados. De acuerdo a la evidencia más reciente, las intervenciones más efectivas para combatir la obesidad infantil son aquellas que involucranactividad física, educación nutricional y entornos de apoyo. Así, en esta revisión nos centramos en buscar dichas intervenciones, que además incluyan seguimientos a medio y largo plazo, monitoreo y evaluación, que son críticos para mantener una acción efectiva.Material y métodos: se incluyó una revisión de artículos científicos publicados en bases de datos especializadas como Pubmed (Medline), the Cochrane Library, The Cochrane Controlled Trials Register (CCTR), ScienceDirect, Scielo, La Biblioteca Cochrane Plus y la página web de la Organización Mundial de la Salud (http://www.who.int).Resultados: de 199 artículos potenciales, sólo 8 fueron incluidos en esta revisión. Los resultados mostraron que aquellas intervenciones multi-componente y de largo plazo tienen beneficios sobre IMC, actividad física y elecciones alimentarias. Sin embargo, pocos estudios mostraron cambios significativos sobrelos hábitos alimentarios generales y sobre la prevalencia de la obesidad. También, se observó que las intervenciones multicomponente que se llevaron a cabo tanto en países en desarrollo de Latinoamérica, como en países desarrollados tuvieron resultados similares.Conclusión: esta revisión demuestra que pueden ocurrir cambios sobre las medidas antropométricas, la actividad física y las elecciones alimentarias cuando se llevan a cabo intervenciones multicomponente en ambientes a nivel de la educación académica primaria, sin importar la localización geográfica, peromanteniendo similar metodología y materiales


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