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Evid Based Nurs 7:106 doi:10.1136/ebn.7.4.106
  • Treatment

Review: most selective serotonin reuptake inhibitors lead to adverse events that appear to outweigh the benefits in children

Selective serotonin reuptake inhibitors (SSRIs) v placebo for depression in children*

SSRI Outcomes at ⩾12 weeks (number of studies) Event rates RRR (95% CI) NNT (CI)
*Abbreviations defined in glossary.
†Includes unpublished data.
‡Studies combined using random effects model; fixed effects model used for all others.
§Calculated from data in article.
Fluoxetine Serious adverse events (1) 0.9% v 3.6% 75% (−122 to 97) Not significant
Weighted RRI (CI) NNH
Suicide attempt (1)† 2.4% v 1.9% 26% (−64 to 340) Not significant
Discontinuation (2)‡ 5.7% v 6.3% 19% (−82 to 685) Not significant
Paroxetine Serious adverse events (2) 12% v 4.4% 155% (23 to 430) 15 (8 to 50)
Suicide attempt/ideation (2) 3.7% v 2.5% 51% (−38 to 269) Not significant
Discontinuation (1) 9.7% v 6.9% 40% (−48 to 278) Not significant
Sertraline Serious adverse events (1) 3.7% v 3.3% 14% (−61 to 232) Not significant
Suicide attempt/ideation (1) 2.6% v 1.1% 143% (−52 to 1139) Not significant
Discontinuation (1) 9.0% v 2.7% 236% (27 to 793) 16 (9 to 59)§
Citalopram Suicide attempt (2) 7.1% v 3.6% 99% (−17 to 377) Not significant
Treatment emergent adverse events (2) 79% v 70% 13% (1 to 27) 12 (6 to 100)
Discontinuation (2) 8.6% v 7.1% 20% (−38 to 135) Not significant
Venlafaxine Suicide related events (2) 7.7% v 0.6% 1277% (83 to 10261) 15 (10 to 34)
Discontinuation (2) 10% v 3.0% 246% (30 to 821) 15 (9 to 50)

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