SSRIs: exploring controversies, conundrums, and contentions-epiphenomenon or empirical ingenuity? A comparative panorama for untangling enigma in children and youths.

IF 3.4 3区 医学 Q2 CLINICAL NEUROLOGY
Mayank Gupta, Theodore A Petti
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引用次数: 0

Abstract

The role of serotonin reuptake inhibitors (SSRIs) in treating psychiatric disorders has been a subject of heated debate since their introduction. Initially celebrated for their potential to address various mental health conditions during the late 1980s and 1990s, SSRIs have since faced significant scrutiny. Critics argue that their benefits may not be as substantial as initially believed. Over the past two decades, concerns have intensified with the emergence of boxed warnings about the risks associated with SSRIs, particularly regarding their link to increased suicidal thoughts in youth. This controversy is further complicated by questions about the integrity of early industry-sponsored trials and the reliability of subsequent National Institute of Mental Health (NIMH) trials. These issues have raised ongoing critical concerns about the effectiveness and safety of SSRIs, especially for treating a range of disorders in children and adolescents. This review seeks to critically appraise by presenting empirical evidence that addresses these controversies. It explores the validity of the monoamine theory, examines the fidelity of early and recent trials, and considers the broader implications for clinical practice. By answering specific, targeted questions, this article aims to clarify the ongoing debate and enhance the understanding of SSRIs' role in mental health treatment. The goal is to support clinicians in making more informed decisions when prescribing these medications and to ensure consideration of the balance between potential benefits and risks for young patients with mental health disorders.

ssri:探索争议、难题和争论——附带现象还是经验独创性?解开儿童与青少年谜题的比较全景。
5 -羟色胺再摄取抑制剂(SSRIs)在治疗精神疾病中的作用自从被引入以来一直是一个激烈争论的话题。在20世纪80年代末和90年代,SSRIs最初因其治疗各种心理健康状况的潜力而受到称赞,但自那以后,它就面临着重大的审查。批评人士认为,它们的好处可能没有最初认为的那么大。在过去的二十年里,随着有关SSRIs风险的黑框警告的出现,特别是关于它们与青少年自杀念头增加的联系,人们的担忧加剧了。关于早期行业赞助试验的完整性和随后国家精神卫生研究所(NIMH)试验的可靠性的问题,使这一争议进一步复杂化。这些问题引起了对SSRIs的有效性和安全性的持续关注,特别是在治疗一系列儿童和青少年疾病方面。本综述试图通过提出解决这些争议的经验证据来进行批判性评估。它探讨了单胺理论的有效性,检查了早期和最近的试验的保真度,并考虑了对临床实践的更广泛的影响。通过回答具体的、有针对性的问题,本文旨在澄清正在进行的争论,并加强对SSRIs在心理健康治疗中的作用的理解。目标是支持临床医生在开这些药物处方时做出更明智的决定,并确保考虑到年轻精神健康障碍患者的潜在益处和风险之间的平衡。
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来源期刊
CNS Spectrums
CNS Spectrums 医学-精神病学
CiteScore
6.20
自引率
6.10%
发文量
239
审稿时长
>12 weeks
期刊介绍: CNS Spectrums covers all aspects of the clinical neurosciences, neurotherapeutics, and neuropsychopharmacology, particularly those pertinent to the clinician and clinical investigator. The journal features focused, in-depth reviews, perspectives, and original research articles. New therapeutics of all types in psychiatry, mental health, and neurology are emphasized, especially first in man studies, proof of concept studies, and translational basic neuroscience studies. Subject coverage spans the full spectrum of neuropsychiatry, focusing on those crossing traditional boundaries between neurology and psychiatry.
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