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Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review
OBJECTIVES: To 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 Dep...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375629/ https://www.ncbi.nlm.nih.gov/pubmed/32690742 http://dx.doi.org/10.1136/bmjopen-2019-036412 |
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author | Westergren, Tone Narum, Sigrid Klemp, Marianne |
author_facet | Westergren, Tone Narum, Sigrid Klemp, Marianne |
author_sort | Westergren, Tone |
collection | PubMed |
description | OBJECTIVES: To 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. DESIGN: Systematic review of clinical guidelines and clinical decision support tools. DATA SOURCES: PubMed, EMBASE, guideline collections, Health libraries. ELIGIBILITY CRITERIA: We 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 SYNTHESIS: Guidelines 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. RESULTS: 19 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. CONCLUSIONS: Guidelines 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. |
format | Online Article Text |
id | pubmed-7375629 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-73756292020-07-27 Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review Westergren, Tone Narum, Sigrid Klemp, Marianne BMJ Open Pharmacology and Therapeutics OBJECTIVES: To 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. DESIGN: Systematic review of clinical guidelines and clinical decision support tools. DATA SOURCES: PubMed, EMBASE, guideline collections, Health libraries. ELIGIBILITY CRITERIA: We 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 SYNTHESIS: Guidelines 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. RESULTS: 19 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. CONCLUSIONS: Guidelines 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. BMJ Publishing Group 2020-07-20 /pmc/articles/PMC7375629/ /pubmed/32690742 http://dx.doi.org/10.1136/bmjopen-2019-036412 Text en © 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/. |
spellingShingle | Pharmacology and Therapeutics Westergren, Tone Narum, Sigrid Klemp, Marianne Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review |
title | Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review |
title_full | Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review |
title_fullStr | Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review |
title_full_unstemmed | Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review |
title_short | Adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review |
title_sort | adverse effects information in clinical guidelines on pharmacological treatment of depression in children and adolescents: a systematic review |
topic | Pharmacology and Therapeutics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7375629/ https://www.ncbi.nlm.nih.gov/pubmed/32690742 http://dx.doi.org/10.1136/bmjopen-2019-036412 |
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