Teen Suicide Risk Similar Among Antidepressants
Increased Teen Suicide Risk Doesn’t Vary Among SSRI Antidepressants
April 12, 2010 -- The heightened risk of teen suicide doesn’t vary among
users of different antidepressants, a new study finds.
Researchers say the finding supports the FDA’s current "black box" warning
on all antidepressants detailing the increased risk of suicide attempts and
suicides in children and teens who start to take the drugs. A "black box"
warning is the FDA's most severe warning label.
Previous studies have shown that children and teenagers who begin to use
SSRI (selective serotonin reuptake inhibitor) antidepressants may have an
increase in suicidal thoughts and behaviors, but researchers say this is the
first study to compare the child and teen suicide risk among different
individual SSRI antidepressants.
The study followed 20,906 children in British Columbia between the ages of
10 and 18 who had been diagnosed with depression and prescribed an
antidepressant over a nine-year period.
During the first year of antidepressant use, there were 266 attempted
suicides and three suicides.
Researchers found no significant difference in child and teen suicide risk
among the five SSRI antidepressants studied (fluoxetine, fluvoxamine, citalopram, paroxetine, and sertraline). Tricyclic antidepressants showed risks
similar to the SSRIs.
Overall, the child and teen suicide rate after initiation of antidepressant
use among participants in the study was five times higher than the rate
reported among all teens aged 13 to 17 in British Columbia, which researchers
say reflects the higher suicide risks among the depressed.
"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," write researcher Sebastian Schneeweiss, MD, ScD of Harvard
Medical School and colleagues in Pediatrics. "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