Reactions 1030 - 4 Dec 2004

Antidepressants do not increasesuicide attempts by adolescentsAntidepressant use does not appear to increase the

risk of suicide attempts by adolescents with majordepressive disorder (MDD), according to researchersfrom the US.

To investigate the association between antidepressantuse and suicide attempts in adolescents, they conducteda retrospective longitudinal cohort analysis involving24 119 patients aged 12–18 years with a new diagnosisof MDD, identified from medical claims records.

When adjusted for propensity, there was nosignificant increase in the risk of suicide attempts withSSRI use (hazard ratio [HR] 1.59; 95% CI 0.89, 2.82),other antidepressant use (HR 1.03; 0.43, 2.44) ormultiple antidepressant use (HR 1.43; 0.7, 2.89),compared with no antidepressant use. In addition,antidepressant use for ≥ 180 days decreased the risk ofsuicide attempts compared with antidepressant use for< 55 days (HR 0.34; 0.21, 0.55). The researchersconclude that their findings "suggest that previousobservations of a relationship between antidepressanttreatment and suicide attempts were, in fact,confounded".Valuck RJ, et al. Antidepressant treatment and risk of suicide attempt byadolescents with major depressive disorder: a propensity-adjusted retrospectivecohort study. CNS Drugs 18: 1119-1132, No. 15, 2004 800882462

» Editorial comment: In October 2004, the US FDA issued aPublic Health Advisory highlighting the addition of a black boxwarning to all antidepressants regarding an increased risk ofsuicidality in children and adolescents [see Reactions 1024: 2,23 Oct 2004; 800969981].

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