Adverse health outcomes associated with antidepressant use may be exaggerated and not supported by evidence, according to the authors of a systematic review.

“No absolute contraindication” emerged in the study, the researchers say, after their finding that reported associations are likely subject to confounding by indication.

International researchers graded evidence from 45 meta-analyses of observational studies with a cohort or case-control design that assessed the association between antidepressant use or exposure and adverse health outcomes.

Convincing evidence emerged from both main and sensitivity analyses for links between antidepressant use and risk of suicide attempt or completion among children and adolescents, the authors write in JAMA Psychiatry.