Antidepressants May Bring Suicidal Thoughts in Children

Study shows that youth on antidepressants may be more at risk for suicide.

Children who start taking antidepressant medication face a slight increase in the risk of suicidal thoughts. That's the conclusion of a recent report by FDA scientists, who recommended "close monitoring of patients as a way of managing the risk of suicidality."

The scientists, who analyzed data from previously published studies, stopped short of recommending that children not be given antidepressants. The antidepressants tested were fluoxetine, sertraline, paroxetine, fluvoxamine, citalopram, bupropion, venlafaxine, nefazodone, and mirtazapine.

The study, co-authored by Thomas Laughren, M.D., examined 24 clinical trials, involving a total of 4,582 subjects. Laughren found 209 suicide-related events, such as attempted suicide or suicidal thoughts, although none of the subjects actually committed suicide. The overall risk of suicidal thoughts or behavior across the studies was 1.95, meaning that 1 in 50 children or teens reported or displayed suicidal thoughts or behavior.

The apparent increase in suicidal thoughts might have resulted from the fact that children taking antidepressants - who experience reduced anxiety and improved communication skills - are more likely than other children to report such thoughts. The researchers pointed to a recent decrease in suicide rates among adolescents to support this possibility.

In a related development, GlaxoSmithKline sent letters to doctors warning that its antidepressant paroxetine (Paxil) seems to raise the risk of suicidal behavior in young adults.