Martin Ploderl explains with crystal clarity that studies find that the effect of antidepressants in children and adolescents do not differ from placebo in effect on depression. Given their clear harms this means that guidelines should no longer recommend these drugs for treating depression in children. Guidelines however continue to do so on outdated studies. @NICEComms and others need to update guidance to prevent avoidable harm Link to Martin’s blog below.

This is certainly the most consequential paper published in child and adolescent psychiatry for the last few years. It shows that the meta-analyses that current child psychiatry guidelines rely on to recommend fluoxetine for depression were skewed by an unbelievable trial (n=40) in Iran which found an effect 15 times larger than the average. When this trial is removed all meta-analyses find the same as a recent Cochrane analysis which found 'small and unimportant differences.' The flawed meta-analyses by Zhou and @cipriani in the @TheLancet and Lancet Psychiatry need to be corrected. And guideline committees need to update their guidance in the context of the harms of these drugs including withdrawal effects, sexual effects and agitation/akathisia and suicidality in a minority of youths exposed to them. Link below

“He said I shouldn’t have been taking Klonopin for so long, almost like I’d been writing my own prescriptions for the past nineteen years.” A powerful account of benzodiazepine withdrawal—and the harm compounded when doctors fail to recognise it. This is just another story which shows why safe tapering and believing patients matters. Link below

Some psychiatrists continue to insist that studies like Henssler prove that withdrawal is not a major concern, ignoring all the biases of the study. Dr Shapiro @BShapiroMD and I try to set the record straight here but I fear we are talking to people with closed ears. Link below