Antidepressants double suicidal behavior in children and adolescents


Last month, a group of researchers published a startling find in the British Medical Journal: Children and adolescents who take antidepressants are twice as likely to exhibit suicidal behavior. The researchers warn that clinicians should be extra cautious when prescribing antidepressants to their younger patients.

The study

Lead author, Tarang Sharma, and her fellow researchers chose to investigate clinical trial reports and raw data from various pharmaceutical companies. They examined data from over 18,500 patients, both children and adults.

The study looked at the effects of five antidepressants: duloxetine, fluoxetine, paroxetine, sertraline and venlafaxine. Some of the drugs were serotonin and norepinephrine reuptake inhibitors (SNRIs), whereas other drugs were selective serotonin reuptake inhibitors (SSRIs). All of these drugs are commonly prescribed for depression, anxiety and other mental illnesses.

The researchers reviewed every study and patient report with a keen eye, noting any serious side effects such as suicidal behavior (defined as suicide attempts or ideation) or aggression.

Thankfully, they found that adults who were prescribed antidepressants did not demonstrate an increase in suicidal behavior. Specifically, the number of suicidal incidents in adults was so low that the researchers could not consider it scientifically significant. (When a number is not scientifically significant, it means that it could be the result of a coincidence.)

The children and adolescents in the clinical trials weren’t as fortunate as the adults. Although the vast majority of them did not experience increased suicidal behavior, a small — but scientifically significant — amount did. As shown in this figure, 35 children and adolescents out of the 1,160 receiving antidepressants experienced suicidal behavior. That means that 97 percent of the patients did not.

Even though the number of suicidal events was relatively small, it was significantly larger than it was in children and adolescents who did not receive antidepressants. In fact, compared to adolescents and children with depression who weren’t on antidepressants, adolescents and children on antidepressants were twice as likely to consider suicide.

“Therefore we suggest minimal use of antidepressants in children, adolescents, and young adults, as the serious harms seem to be greater, and as their effect seems to be below what is clinically relevant,” wrote the authors in the paper.

Should adolescents and children receive antidepressants?

The results of this study indicate that clinicians need to be particularly careful when prescribing antidepressants to children and teens. Even though the risk of developing suicidal behavior is relatively low, it is considerably higher than in adolescents who don’t receive antidepressants.

Of course, it could be possible that adolescents who are prescribed antidepressants are dealing with more severe mental illness — hence why they’re given antidepressants in the first place — and are therefore more prone to suicidal behavior. More research is necessary before the landscape of depression medication changes. Until then, it’s best to remain cautious and keep a close eye on children and adolescents who are prescribed antidepressants.

White River Academy is a therapeutic boarding school designed to help teen boys who struggle with substance abuse, mental health issues including depression and suicidal ideation, and co-occurring conditions. All students who attend White River Academy are provided with therapists, psychiatrists and certified teachers who have been specially trained to help adolescents regain control of their lives. For more information, call our 24/7 helpline.

About the author

Courtney Lopresti, M.S., uses her scientific background to write online blogs and articles for a general audience. At the University of Pittsburgh, where she earned her Master’s in neuroscience, she used functional neuroimaging to study how the human cerebellum contributes to language processing. In her spare time, she writes fiction, reads Oliver Sacks and spends time with her two cats and bird. Courtney is currently located in Minneapolis.

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