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Journal of Child Neurology
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Cardiovascular and Neurological Adverse Events Associated With Antidepressant Treatment in Children and Adolescents

Jeanette M. Jerrell, PhD

Department of Neuropsychiatry University of South Carolina School of Medicine, Columbia, South Carolina, jjerrell{at}gw.mp.sc.edu

Roger S. McIntyre, MD, FRCPC

Departments of Psychiatry and Pharmacology University of Toronto, Canada

A retrospective cohort design of Medicaid medical and pharmacy claims for 1996 through 2005 was employed for 14 171 children and adolescents prescribed an antidepressant medication and a random sample of 4500 children not treated with any class of psychotropic medication to compare the prevalence rates of cardiovascular and neurological adverse events. The treated cohort evinced a higher prevalence of cardiovascular events, orthostatic hypotension, seizures, insomnia, and headaches. In the treated cohort, patients were at a significantly higher risk for incident cardiovascular events when exposed to selective serotonin reuptake inhibitors and weight-inducing antidepressants, mood stabilizers, and antipsychotics. Incident orthostatic hypotension was associated with weight-inducing antidepressants and mood stabilizers. Incident seizures and extrapyramidal symptoms were unrelated to antidepressant or co-prescribed psychotropic medications, but both were significantly associated with comorbid central nervous system, organic brain/mental retardation, or preexisting cardiovascular or cerebrovascular conditions. Headaches and dizziness were significantly related to taking mood stabilizers.

Key Words: antidepressants • serotonin reuptake inhibitors • neurological adverse events • cardiovascular adverse events

Journal of Child Neurology, Vol. 24, No. 3, 297-304 (2009)
DOI: 10.1177/0883073808323523
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