Suicidality with individual antidepressants in pediatric patients

January 01, 0001

Suicidality with individual antidepressants in pediatric patients

Antidepressant have a black box warning regarding suicidality in children, though some data suggests differences between different antidepressant. These US and Canadian researcher sought to assess the risk of suicide attempts and suicides after initiation of antidepressants in pediatric patients, examining individual agents. They performed a 9-year cohort study using population-wide data from British Columbia.

The authors found: "Of 20,906 children who initiated antidepressant therapy, 16,774 (80%) had no previous antidepressant use. During the first year of use, we observed 266 attempted and 3 completed suicides, which yielded an event rate of 27.04 suicidal acts per 1000 person-years. There were no meaningful differences in the rate ratios (RRs) comparing fluoxetine with citalopram (RR: 0.97), fluvoxamine (RR: 1.05), paroxetine (RR: 0.80), and sertraline (RR: 1.02). Tricyclic agents showed risks similar to those of selective serotonin reuptake inhibitors (RR: 0.92)."

The authors concluded: "Our finding of equal event rates among antidepressant agents supports the decision of the Food and Drug Administration to include all antidepressants in the black box warning regarding potentially increased suicidality risk for children and adolescents beginning use of antidepressants."

This study lends credence to the notion that in pediatric patients suicidality risk is equivalent across antidepressants.

For the full abstract, click here.

Pediatrics 125(5):876-888, May 2010
© 2010 American Academy of Pediatrics
Comparative Safety of Antidepressant Agents for Children and Adolescents Regarding Suicidal Acts. Sebastian Schneeweiss, Amanda R. Patrick, Daniel H. Solomon, et al.

Category: P. Psychological. Keywords: antidepressant medications, fluoxetine, suicide, suicidality, epidemiology, study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 4 June 2010

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