Most antidepressants are generally safe. However, the Food and Drug Administration (FDA) requires all antidepressants carry black box warnings about the potential risk of increased suicidal thinking and behavior in some children and young adults under the age of 25.
According to the Mayo Clinic:
“Although antidepressants are more likely to reduce suicide risk in the long run by improving mood, in some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.”
SSRIs
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants, the Mayo Clinic notes, because they can ease symptoms of moderate to severe depression, are relatively safe and typically cause fewer side effects than other types of antidepressants do. However, they also carry an increased risk of suicidal ideation in some individuals.
SSRIs approved by the FDA for the treatment of depression include:
- Citalopram (Celexa).
- Escitalopram (Lexapro).
- Fluoxetine (Prozac).
- Paroxetine (Paxil, Pexeva).
- Sertraline (Zoloft).
SSRI ALTERNATIVES
SSRI alternatives for people affected by depression or anxiety disorders include serotonin-norepinephrine reuptake inhibitors (SNRIs) sold as
- Effexor (venlafaxine).
- Pristiq (desvenlafaxine).
- Cymbalta (duloxetine).
Another alternative to SSRIs, Bupropion (sold under the brand name Wellbutrin) may cause some people to be agitated, irritable, or display other abnormal behaviors. It may also cause some people to have suicidal thoughts and tendencies, or to become more depressed, which is why it is so important that your doctor check your progress at regular visits to make sure the medicine is working properly and to check for unwanted effects.
CONCLUSIONS ARE INCONSISTENT
Despite several studies that have reviewed the suicidal risk of antidepressants, the conclusions remain inconsistent, according to a study published by Frontiers in Psychiatry, which performed a meta-analysis of observational studies conducted from January 1990 to April 2021 to address the association between exposure to antidepressants and the risk of suicide and suicide attempt in children and adolescents aged 5–25 years.
The study showed antidepressant exposure significantly increased the risk of suicide and suicide attempt when compared with no antidepressant usage among children and adolescents. Adding, however, that since untreated depression remains one of the largest risk factors for suicide and the efficacy of antidepressants is proven, clinicians should evaluate carefully their patients and be cautious with patients at risk to have treatment emergence of symptoms or worsening of suicidal ideation when prescribing antidepressants to children and young patients.
If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help.
If you are having thoughts of suicide, text the National Suicide Prevention Lifeline at 988 or go to SpeakingOfSuicide.com/resources for a list of additional resources.
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The Grief Project 