To recognize World Suicide Prevention Day, I wanted to post again about the topic of medications, suicide and young people.
First, the sad statistics: Worldwide, suicide is the second-leading cause of death among young people ages 15 to 19. In the United States, according to the CDC, suicide was the third-leading cause of death in 2009 for people ages 10-14, 15-19 and 20-24. It was the second-leading cause of death for people ages 25 to 34.
The vast majority of people who commit suicide have a mental illness. But for nearly a decade doctors and researchers have been debating whether certain classes of medications used to treat mental illness increase or decrease the risk of suicide – as well as suicidal thoughts and behaviors – in young people.
In 2004, the FDA placed a black-box warning on all antidepressants, warning that they increase the risk of suicidal thinking and behavior (called “suicidality”) in children and teens.
An FDA analysis had found that one type of antidepressants in particular, the SSRIs, which include Prozac, Zoloft, Paxil, Lexapro and others, doubled the risk of suicidality in young people from 2% to 4%. But it found no completed suicides in the studies it looked at, which included some 2,200 children.
In 2005, the European medications regulatory authority urged European countries to put strong warnings about using either SSRI antidepressants, or SNRI antidepressants, such as Effexor and Cymbalta, for children or teens. The warning was based on the drugs’ potential to induce suicidality and hostile or aggressive behavior.
Also in 2005, the UK’s National Health Service issued guidelines urging doctors to avoid prescribing antidepressants to kids under 18 unless other therapies for depression didn’t work.
In 2007, the FDA expanded its black box warning on antidepressants to include all young people under age 25. The risk is greatest in the first month or two of treatment, the FDA warned.
After the U.S. and European warnings went into effect, prescribing of antidepressants to children and teens decreased. At the same time, some …