Recovery Michigan

Of the trials included in the analysis, 65 percent of them were funded by drug companies, 29 percent were rated as having high risk of bias, 59 percent had moderate risk of bias, and 12 percent had low bias risk.

In 34 of the trials - including 5,260 participants of average age 9-18 years - the researchers identified only one antidepressant, fluoxetine, for which the benefits outweighed the risks when it came to efficacy and tolerability.

Compared with placebos and seven other antidepressants, nortriptyline was found to have lower efficacy.

The antidepressants imipramine, venlafaxine, and duloxetine fared worst when it came to tolerability, the researchers found; there were many more discontinuations with these drugs than with placebos.

Compared with placebos and five other antidepressant medications, venlafaxine was found to increase the risk of suicidal thoughts and attempts.

These results, say the authors, suggest that the vast majority of antidepressants are ineffective for children and adolescents with major depression, and many of them may be unsafe.