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Benefits and Harms of Pediatric Antidepressant Medications—Reply
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In Reply: Dr Waslick is concerned that our analysis might inflate the risk-benefit ratio for antidepressants by concentrating only on the risk of treatment-emergent suicidal ideation and attempts. Our intent was not to mislead, but rather to explicitly compare the benefit of antidepressants to the risk of treatment-emergent suicidal ideation/suicide attempt, because this is the adverse effect that is the most frightening, has engendered the most negative publicity, has resulted in a black box warning from the US Food and Drug Administration, and has been associated with a decrease in use of antidepressants in children and adolescents.1-2 We explicitly acknowledged this limitation in the Comment section. Although we could have been clearer in defining what was meant by a risk-benefit ratio, we assume that most readers regard treatment-emergent suicidal ideation and behavior to be in a different category of concern than discontinuation of treatment because of adverse somatic symptoms. We . . . [Full Text of this Article]
Jeffrey A. Bridge, PhD
Columbus Children's Research Institute
Columbus, Ohio
Boris Birmaher, MD;
David A. Brent, MD
brentda@upmc.edu
Western Psychiatric Institute and Clinic
Pittsburgh, Pennsylvania
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