Antidepressants Carry Equal Risks

For very a decade, the public has heeded warnings of suicidal behavior related to antidepressant use in kids and adolescents. However, the use of antidepressants in this population is still increasing. Initially, selective serotonin reuptake inhibitors (SSRIs), the most common class of antidepressants prescribed for kids, were the only drugs associated with the increase in suicidal behavior. Now, a huge cohort study published in a recent issue of Pediatrics reports that there is no difference in the risk of suicidal behavior among different SSRIs or difference classes of antidepressants.


The United States Food and Drug Administration (FDA) issued a public warning in October 2004 that cautioned about an increase in suicidal thoughts and behaviors in kids and adolescents taking SSRIs. Later, the FDA necessary a “black box warning” — the most serious type of warning obtainable — be placed on the labeling of SSRIs detailing the increased suicidal risks. The warning came after a 2007 study in the Journal of the American Medical Association found that the risk of suicidal thoughts and attempts in young patients taking SSRIs was once the rate of patients taking placebo.

However, plenty of patients, parents and prescribers were skeptical of the results and the use of SSRIs in kids and adolescents has continued to increase over the past several years. Several studies and reviews since the issuance of the FDA’s warning have not duplicated the increased suicidal behavior, and plenty of clinicians and patients feel that the benefits of antidepressant therapy outweigh the risks. A landmark study funded by the National Institute of Mental Health, the Treatment for Adolescents with Depression Study (TADS), concluded that a combination of fluoxetine (an SSRI) and psychotherapy is the most effective treatment for depression in young patients.

Several studies have also analyzed the relationship between antidepressant use in adults and suicide risk, but have yielded conflicting results. Further, several huge studies found no increase in suicidal behavior in young people, either. One study even reported that SSRI use was associated with decreased suicidal behavior in kids and adolescents.