Recent research has shown that suicidal thinking is more common
among children who take antidepressants. But children who take antidepressants
don't actually commit suicide more. They just think and attempt suicide slightly more.
The specific type of medication that was studied is called selective serotonin reuptake
inhibitors - or SSRI for short. Many studies have found SSRIs to be effective in
treating depression in children. SSRIs are especially effective when combined with therapy.
However it is very hard to know whether SSRIs do or do not
increase the risk of completed suicide. There are two reasons for this.
Depression itself increases the risk for suicide; and,
Completed suicide is a rare event.
There is some evidence that shows suicide is lower in people who
take antidepressants. For example, in Sweden the suicide rate is 50% lower
for people treated with antidepressants. For U.S. adolescents an
increase in the use of antidepressants was associated with a decrease in the rate of suicides.
On the other hand, children treated with antidepressants may
think about suicide more. It is possible that as depression lifts a child
is energized enough to act on thoughts of self-harm. Also children may be
more apt to say what they are really thinking once treatment is underway.
But no one knows for sure. For this reason, the FDA has placed a warning
about suicide risk on antidepressants.
Discuss the risks and benefits of antidepressants with your doctor.
For most children, the benefits of taking an antidepressant outweigh the risks.
All children taking antidepressants should be monitored closely by a doctor.
This is especially important in the first 4 weeks of taking an SSRI. If your
child is already using antidepressants know the warning signs.
When to worry:
Your child talks about new or more frequent thoughts of wanting to die.
Your child hurts him/herself on purpose or is aggressive.
Your child is very anxious, panicky, agitated, or impulsive.
Your child is overly restless.
Your child is overly elated or manic. This would might look
like driven fast speech or unrealistic plans.
Adapted in part from the NIMH Antidepressant Medications
for Children and Adolescents: Information for Parents and Caregivers accessed on
October 20, 2005 at http://www.nimh.nih.gov/healthinformation/antidepressant_child.cfm.
