Use of selective serotonin reuptake inhibitors and youth suicide: making sense from a confusing story.
OBJECTIVE
This review provides an update on use of selective serotonin reuptake inhibitors and youth suicide, and describes an informed examination of the social and professional dimensions of this issue.


RESULTS
Recent studies, using various methodologies to analyze experimental and observational data, suggest that concerns about the effect of selective serotonin reuptake inhibitors on suicide and suicide-related phenomena may have been overstated. Also, contrary to much public and medical opinion, treatment of depression with selective serotonin reuptake inhibitors does not increase but rather may decrease youth suicide fatalities. A recent reanalysis by the US Food and Drug Administration of existing data from clinical trials across the lifespan suggest an age-dependent effect on nonfatal suicide attempts and suicidal ideation, in which risk appears to be increased in youth and reduced from mid-adulthood and onward.


CONCLUSIONS
Selective serotonin reuptake inhibitors are a modestly effective and generally safe treatment for postpubertal major depressive disorder, but their use requires collaborative decision making and a predetermined, shared monitoring plan.
Kutcher
Stan
S
Department of Psychiatry and the World Health Organization/Pan American Health Organization Collaborating Center, Halifax, Canada. Stan.Kutcher@dal.ca
Gardner
David M
DM
D000293:Adolescent; D015982:Bias; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States; D014486:United States Food and Drug Administration; D000092864:Suicide Prevention
D017367:Selective Serotonin Reuptake Inhibitors