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Antidepressant medications may be associated with suicide attempts and death in severely depressed children and adolescents but not in adults, according to an article in the August issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

The U.S. Food and Drug Administration (FDA) recently began requiring drug manufacturers to include a warning regarding the risk of suicidal behavior among children and teens treated with antidepressants after a large analysis of clinical trials revealed a potential link. It is uncertain whether there is an association between treatment with antidepressants and suicidal behavior in adults, according to background information in the article. Because relatively few completed suicides occur, suicidal behavior is used instead in studies assessing the risks associated with antidepressant medications and few studies have examined the risk of suicide attempts or deaths in patients treated with antidepressants.

Mark Olfson, M.D., M.P.H., College of Physicians and Surgeons of Columbia University Medical Center and New York State Psychiatric Institute, New York, and colleagues analyzed the medical records of 5,469 Medicaid patients who were hospitalized for depression at least once in 1999 or 2000. The researchers first selected all cases of completed suicides (eight children and adolescents and 86 adults) and suicide attempts (263 children and adolescents, 521 adults). They then matched each case with one to five controls based on demographic information, period following hospital discharge, presence or absence of a suicide attempt prior to hospital admission, state of residence, other medication use and presence or absence of a substance abuse disorder.

Severely depressed children and adolescents ages 6 to 18 years were 1.5 times as likely to attempt suicide and also significantly more likely to complete suicide if they were treated with an antidepressant medication than if they were no
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Contact: Craig LeMoult
212-305-0820
JAMA and Archives Journals
7-Aug-2006