Antidepressants are prescription drugs that are used to combat depression and other medical conditions. SSRIs, or selective serotonin reuptake inhibitors, are one of the most common forms of antidepressants currently prescribed. This is in large part due to the effectiveness of certain SSRIs in treating depression and anxiety in children, teenagers, and young adults. However, these drugs have also been associated with increased occurrence of suicidal thoughts in those particular age groups.
In 2004, the FDA began to require a “black box warning” alerting patients to the increased risk of suicidal thoughts and tendencies in youths using antidepressants. In 2006, this was extended to include adults up to the age of twenty-four. A “black box warning” is the most serious type of warning issued for a prescription drug. The only SSRI currently approved by the FDA for treating depression in children ages eight and older is fluoxetine, commonly known as Prozac.
Suicide and Antidepressants
Suicidal thoughts and tendencies are common in people that have been diagnosed as having extreme depression or anxiety disorders. Therefore, it is extremely difficult to determine whether these thoughts have been increased or simply unaffected by drug treatment. It should also be noted that individuals respond differently to these medications. This makes it difficult to predict with any accuracy the exact reaction a person will have when starting a new medication.
The best way to effectively battle this occurrence is to be aware of common warning signs of suicidal thinking and to closely monitor the person immediately following the introduction to the new medication. It is also highly recommended that patients who have been prescribed antidepressant medication seek some sort of psychotherapy in addition to the medication.
Some of the warning signs of suicidality include:
- Detachment from regular social interactions
- Increased aggression or hostility
- Akathisia , or extreme restlessness
- Trouble sleeping
- Mood swings
Studies on Antidepressants and Suicide
During Zoloft clinical trials, it was originally published that one suicidal incidence occurred. However, later information from the Center for Drug Evaluation and Research revealed that six suicidal incidences were documented by the FDA. In addition, 17 children involved in the study withdrew due to serious adverse events.
In 2003, the Committee on Safety of Medicines conducted a study on antidepressants and suicide in the United Kingdom. The study found that depressed children taking SSRIs had higher occurrences of suicidal thoughts or self-harm attempts than children taking a placebo.
The Medicines and Healthcare Products Regulatory Agency (MHRA) of London published related data in 2003. The data indicated that sertraline hydrochloride, found in Zoloft and Lustral, was ineffective for treating major depressive disorder in adolescents and children. Additionally, one trial showed sertraline to increase self-harm rates in comparison to a placebo.
Antidepressant Effectiveness Studies
In one major clinical trial conducted by the National Institute of Mental Health, four test groups were monitored to determine the most effective form of treatment for adolescents diagnosed with depression. The first group was given only the medication, the second group only therapy, the third group both therapy and medication, and the last group was given a placebo.
After twelve weeks, researchers found that 71 percent of the group receiving both forms of treatment had responded to the treatment, while only 61 percent of the group that had been given medication only, 43 percent of the therapy only group, and 35 percent of the placebo group showed a response. It is to be noted that the rate of suicidal thinking decreased among all the groups over the span of twelve weeks.
A study conducted by the Department of Psychiatry and Psychotherapy, based in Munich, Germany, determined that the incidence of suicidal thoughts, attempts, and completions reduced significantly in adults treated for depression using SSRIs. Many studies have shown similar findings, showing a direct correlation between age and incidence of suicidality after beginning SSRI treatment.