Antidepressant Formulas Do Not Vary in Threat of Teen Suicide Risk Increase

Though suicide risk is increased among children and teens on antidepressants, a recent study verifies the FDA’s claim that the risk is not heightened by use of particular formulas of SSRI (selective serotonin reuptake inhibitor) antidepressant medications.

SSRI antidepressants combat depression by increasing the amount of the feel-good compound serotonin that is available for absorption by receptors in the brain. The result is effective treatment for depression, anxiety and chronic pain, but a common side effect is an increase in suicidal thoughts and behaviors in the depressed.

Currently, the FDA’s “black box” warning label is printed on all antidepressant medication packaging and warns of the increased risk of suicidal thoughts and behaviors linked to use of antidepressants. Statistics have indicated an increased risk of these thoughts and behaviors in children and teens taking SSRI medications. A recent study was the first to investigate the possibility that particular SSRI formulas may heighten the risk.

A longitudinal study was conducted over a nine-year period of 20,906 children in British Columbia, ages 10 through 18, who were diagnosed with depression and prescribed antidepressant medication. The study reported 266 suicide attempts and three suicides during the first year of antidepressant use by study subjects taking one of five SSRI antidepressant medications: citalopram, fluoxetine, fluvoxamine, paroxetine, or sertaline.

Study results indicated no significant difference in the risk of child and teen suicidal thoughts or behaviors between the five different antidepressant medication formulas. In addition, tricyclic antidepressants, which are the oldest class of antidepressant medications and have been found to have common and serious side effects, were determined to have suicide risks similar to those of SSRI medications.

Analyzing suicide statistics for teens aged 13 to 17 in British Columbia, researchers concluded that the risk of suicide among teens taking antidepressant medication is five times that of the average risk for teenaged members of the general population. Indeed, a definite link between depression and risk of suicide has been confirmed once again.

Researcher Sebastian Schneeweiss, M.D., an Associate Professor of Medicine at Harvard Medical School, summarizes the study’s conclusions: “Our analysis supports the decision of the Food and Drug Administration to include all antidepressants in the black box warning regarding increased suicidality risk for children and adolescents initiating use of antidepressants.”

Noting the importance of widespread awareness of the increased risk of suicidal thoughts and behaviors in children and teens being treated with antidepressant medications, Dr. Schneeweiss stresses the necessity of particular monitoring of young patients seeking relief from depression. Schneeweiss writes, “Once a decision to initiate pharmacotherapy is made, treatment decisions should be made on the basis of efficacy and less so on the basis of safety. Clinicians should be vigilant in monitoring children and adolescents for whom use of any antidepressant agents is initiated.”