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To The Editor: Dr Bridge and colleagues¹ performed a systematic review and meta-analysis of the risks and benefits of antidepressant medications for pediatric psychiatric disorders. It seems misleading to limit the issues of risk and harm to treatment-emergent suicidality, when in actual practice other adverse reactions that make these medications intolerable for young persons occur much more regularly.

For example, a pooled analysis of clinical trial data across disorders in pediatric participants that examined sertraline, a selective serotonin reuptake inhibitor (SSRI), calculated number needed to harm (NNH) by defining harm as the need to discontinue treatment due to the occurrence of an adverse event.² The NNH was estimated at 15, an order of magnitude lower than the NNH calculated by Bridge et al, in which the definition of harm was limited to treatment-emergent suicidality. A complete discussion of the risks and benefits of these medications must take into account all . . . [Full Text of this Article]

Bruce Waslick, MD
bruce.waslick@bhs.org
Department of Psychiatry
Baystate Medical Center
Springfield, Massachusetts

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