Suicidality in Pediatric Patients Treated With Antidepressant Drugs

Hammad, Tarek A.; Laughren, Thomas; Racoosin, Judith A.

doi:10.1001/archpsyc.63.3.332

Cited by 913 publications

(637 citation statements)

References 12 publications

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“…Looking at the method for suicide, the decline in suicide by overdosing with medications may be related to the introduction of less toxic antidepressant medication such as the selective serotonin reuptake inhibitors (although some authors have indicated that the use of antidepressant drugs in pediatric patients is associated with a modestly increased risk of suicidality [12]). The use of more lethal suicide methods by girls in recent years may be a product of changes in cultural patterns that allow girls and women in general to hold similar roles in contemporary Italy as their male counterparts.…”

Section: Discussionmentioning

confidence: 99%

Suicide among Italian adolescents: 1970–2002

Pompili

Masocco

Vichi

et al. 2009

Eur Child Adolesc Psychiatry

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The purpose of the present study was to analyze sex and regional differences in the suicide rate of adolescents and the methods they used for suicide in Italy during the period 1970-2002. Temporal trends and regional variations in suicide for Italian adolescents were retrieved from the Italian database on mortality for the period 1970-2002, collected by the Italian Census Bureau and processed by the Italian National Institute of Health-Statistics Unit. In the period 1970-2002, 3,069 adolescent suicides were monitored in Italy. Analyses of these suicides identified significant differences by region of residence and sex. Males were 2.1 times more likely than females to kill themselves. Male and female suicides had inverse trends in the years analyzed, so that the sex difference at the present time is the result of a continuous increase in male suicides and a decrease in female suicides since 1970. The dramatic peaks observed over the time period studied cannot be attributed to a single cause, indicating that further studies are needed to better understand the phenomenon.

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Section: Discussionmentioning

confidence: 99%

Suicide among Italian adolescents: 1970–2002

Pompili

Masocco

Vichi

et al. 2009

Eur Child Adolesc Psychiatry

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“…Such work is important in mood and anxiety disorders, given emerging data on amygdala function in these conditions (6,12), coupled with questions surrounding therapeutics. For instance, it is unclear why youth show a different pattern of responses to antidepressant medications, including a possible increased risk of suicidal ideation, than adults (19). Similar questions have emerged about CBT, as one recent study in adolescent MDD found that CBT alone showed no advantage over pill-placebo, but CBT was helpful when combined with fluoxetine (20).…”

mentioning

confidence: 99%

fMRI predictors of treatment outcome in pediatric anxiety disorders

et al. 2006

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“…Independent review of adverse events from data from 24 placebo-controlled trials of AD use in children and adolescents found that suicidality significantly increased with SSRI treatment compared to placebo, leading the FDA to issue a “black box” warning (see Brent, 2004; Goodman et al , 2007; Newman, 2004). Additional studies have likewise found evidence of increased suicidality with use of SSRIs in juveniles, suggesting that there may be an unfavorable risk to benefit ratio for SSRIs (with fluoxetine as a possible exception) (Bailly, 2008; Barbui et al , 2009; Bridge et al , 2007; Cipriani et al , 2005; Doggrell, 2005; Fergusson et al , 2005; Goodman et al , 2007; Hammad et al , 2006; Laughren, 2006; Mosholder and Willy, 2006; Olfson and Marcus, 2008; Olfson et al , 2006; Richmond and Rosen, 2005; Ryan, 2005; Scahill et al , 2005; Tiihonen et al , 2006; Vitiello and Swedo, 2004; Whittington et al , 2004; Wohlfarth et al , 2006). Many of these and other studies have pointed out difficulties in interpretation of the data and have stated that there is considerable risk for suicidality if pediatric patients are not adequately treated (e.g., Bridge et al , 2007; Mann et al , 2006).…”

Section: Discussionmentioning

confidence: 99%

Paroxetine-Induced Increase in Activity of Locus Coeruleus Neurons in Adolescent Rats: Implication of a Countertherapeutic Effect of an Antidepressant

West

Ritchie

Weiss

2010

Neuropsychopharmacol

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Concern that antidepressant (AD) drugs, especially selective serotonin reuptake inhibitors and paroxetine (PAR) in particular, can increase suicidality during the early treatment of juvenile patients (children and adolescents) has created a dilemma for clinicians treating depressives. Though preclinical research cannot resolve controversy in this area, our present findings may provide insight into how AD drugs might, under certain conditions, exacerbate rather than ameliorate the depressive state. Both clinical and preclinical evidence indicates that the principle noradrenergic cell group in the brain, the locus coeruleus (LC), is over-active in depressives and that, conversely, effective AD treatments decrease activity of LC neurons. We report here that short-term (2 and 4 day) administration of PAR produces an increase in the activity of LC neurons (spontaneous firing rate and sensory-evoked responses) in young rats, contrary to the “therapeutic” decrease in activity typically observed in adult rats. Blood levels of PAR were lower in young rats than in adult rats, though similar low blood levels produced by a lower dose of PAR in adult rats failed to produce an increase in LC activity. Additionally, activity of young rats in the swim test was determined to assess depressive-like responses. The same dose/durations of PAR which produced the largest increases in LC activity in young rats produced decreases in swim-test activity, indicating that brief administration of PAR in young rats can promote, rather than reduce, the depressive state. These results offer a model which may help screen potential adjunctive treatments to avoid early adverse effects of ADs.

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Suicidality in Pediatric Patients Treated With Antidepressant Drugs

Abstract: Use of antidepressant drugs in pediatric patients is associated with a modestly increased risk of suicidality.

Cited by 913 publications

References 12 publications

Suicide among Italian adolescents: 1970–2002

Suicide among Italian adolescents: 1970–2002

fMRI predictors of treatment outcome in pediatric anxiety disorders

Paroxetine-Induced Increase in Activity of Locus Coeruleus Neurons in Adolescent Rats: Implication of a Countertherapeutic Effect of an Antidepressant

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