Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
Pediatrics. 2010 May;125(5):876-88. doi: 10.1542/peds.2009-2317. Epub 2010 Apr 12.

Comparative safety of antidepressant agents for children and adolescents regarding suicidal acts.

Author information

  • 1Harvard Medical School, Brigham and Women's Hospital, Department of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Boston, MA 02120, USA. schneeweiss@post.harvard.edu

Abstract

OBJECTIVE:

The objective of this study was to assess the risk of suicide attempts and suicides after initiation of antidepressant medication use by children and adolescents, for individual agents.

METHODS:

We conducted a 9-year cohort study by using population-wide data from British Columbia. We identified new users of antidepressants who were 10 to 18 years of age with a recorded diagnosis of depression. Study outcomes were hospitalization attributable to intentional self-harm and suicide death.

RESULTS:

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 (95% confidence interval [CI]: 23.9-30.5 suicidal acts per 1000 person-years). There were no meaningful differences in the rate ratios (RRs) comparing fluoxetine with citalopram (RR: 0.97 [95% CI: 0.54-1.76]), fluvoxamine (RR: 1.05 [95% CI: 0.46-2.43]), paroxetine (RR: 0.80 [95% CI: 0.47-1.37]), and sertraline (RR: 1.02 [95% CI: 0.56-1.84]). Tricyclic agents showed risks similar to those of selective serotonin reuptake inhibitors (RR: 0.92 [95% CI: 0.43-2.00]).

CONCLUSION:

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.

Comment in

PMID:
20385637
[PubMed - indexed for MEDLINE]
PMCID:
PMC2884182
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk