Antidepressants cut risk of hospital readmission for suicidal youth

Suicidal adolescents who were prescribed an antidepressant medication during inpatient psychiatric hospital treatment were 85 percent less likely than others to be readmitted within a month after discharge, a new study found.

The results provide additional evidence that antidepressants may play a key role in helping improve the mental health of suicidal youth, said Cynthia Fontanella, co-author of the study and assistant professor of social work at Ohio State University.

The findings are especially important now, because antidepressant use dropped in 2003 after the Food and Drug Administration issued a black box warning that some antidepressants may increase the risk of suicidal behavior for pediatric patients. A black-box warning is the most serious type of warning in prescription drug labeling.

"We found that antidepressant treatment had a protective effect on readmission," Fontanella said. "Although the findings are preliminary, our results should be reassuring to child psychiatrists who may have been concerned about prescribing antidepressants since the FDA warning."

But another key finding from the study showed that hospitalized youth who were prescribed three or more medications from different drug classes for mental health issues had a 3-fold increased risk of being readmitted within a month of discharge.

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When to Avoid Antidepressants in Bipolar Patients

Patients with bipolar depression who exhibit even minimal manic symptoms are at heightened risk for switching into mania if they receive antidepressant medication, according to a new report from the Bipolar Collaborative Network.1

This finding from the multinational sites of the former Stanley Foundation Bipolar Network emerged in a post hoc analysis of 176 patients who participated in a 10-week controlled trial of adjunctive antidepressant medication for bipolar I or II depression. The investigators sought to identify clinical correlates for the development of treatment-emergent affective switching from patient demographics and baseline symptoms.

Possible risk factors for affective switch, which have been previously suggested, include comorbid substance abuse, younger age, decreased thyroid-stimulating hormone, and rapid cycling. Although none of these factors were predictive in this study, the investigators acknowledged that their modest effect size precluded ruling these out in other populations. They characterize this study, however, as the first controlled assessment of antidepressant treatment in bipolar depression to correlate a specific phenomenological presentation at baseline with affective switching in subsequent antidepressant treatment.

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Antidepressant treatment may reduce male fertility

Treatment with paroxetine (Paxil), which belongs to the selective serotonin reuptake inhibitor (SSRI) class of antidepressant drugs, increases DNA fragmentation in sperm, according to research presented today at the 64th annual meeting of the American Society for Reproductive Medicine in San Francisco.

Although the study did not directly evaluate male fertility, the five-fold increase in the number of men who developed abnormal sperm DNA while being treated with paroxetine is "troubling" and "suggests an adverse effect on fertility," co-investigator Dr. Cigdem Tanrikut, from Harvard Medical School in Boston, told Reuters Health.

In a clinical trial she described as "the first study to assess the impact of an SSRI on semen parameters in healthy men," 35 men took paroxetine for 5 weeks. The drug was administered in once-daily doses of 10 mg the first week, 20 mg in the second week, 30 mg the third and fourth week, and 20 mg in the fifth week.

READ MORE @ REUTERS UK