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Allison Powell

Dr. Mary Wells

Psy 2217

1/30/19

Suicide Risk in the Use of Antidepressants with Children and Adolescents

In recent years, there has been ongoing debate surrounding the treatment of depression in

children and adolescents using anti-depressants due to the potential resulting increase in risk of

suicidal ideation. Many studies are being done to investigate the issue to determine if anti-

depressants, do in fact, prompt suicidal ideation in children and adolescents with depression and

if so, why that reaction may occur. A meta-analysis of the NIMH-funded Treatment for

Adolescents with Depression Study (TADS,) published in the May 2009 issue of the Journal of

Clinical Psychiatry, assessed the efficacy of antidepressants and risk of reported suicidal

ideation/ attempts in pediatric major depressive disorder (MDD), obsessive-compulsive disorder

(OCD), and non-OCD anxiety disorders. The meta-analysis found an increase in risk of suicidal

behavior as a result of anti-depressants, but did not find the risk high enough to be statistically

significant. It states that the concern about antidepressants must be considered along with the

potential benefits. The research shows that the participants with suicidal ideation present prior

the study had an increase in suicidal ideation while being medicated. Antidepressants did not,

however, statistically prove causation for the increase in suicidal ideation among those who did

not have it present prior. One major clinical trial, TADS, found that the most effective treatment

of depression in children and adolescents to be a combination of both psychotherapy and

medication. In the trial, the medicated group showed a reduction in suicidal thinking, the group

receiving Cognitive Behavioral Therapy (CBT) showed an even greater reduction, and the group
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that received a combination of both medication and CBT showed the greatest reduction in

suicidal thinking.

Due to the lack of research regarding the risks of antidepressants in children and

adolescents, I believe that the decision to use these medications should be made carefully and on

a case-by-case basis. Because there are so many proven benefits of the medication and because

the risk of suicidal ideation is less common, I believe that medication should not be disregarded

as a treatment option, but should be done carefully, with a doctor closely monitoring each

individual. I also believe that the best treatment plan would involve psychotherapy alongside

medication to ensure that suicidal ideation is not increased and that the medication is not having

adverse effects.