Antidepressant Medication Use and Suicide in Children and Adolescents

What are the symptoms of depression in adolescents?

Depression in children manifests as irritability, whining/crying, boredom, failure to gain weight, difficulty sleeping, hyperactivity or inactivity, negative self-comments. Depression in adolescents shows up as aggressiveness, argumentativeness, isolation, boredom, weight changes, difficulty falling asleep or staying asleep, difficulty focusing, and self-criticism.

How common is depression in adolescents?

Studies have shown that about three percent of children and five percent of adolescents experience depression. Those with biological relatives who suffer from depression, anxiety, or substance abuse are more likely to develop depression.

What are antidepressant medications?

Antidepressants are medications that are used to treat depression. There are several types of antidepressant medications. Serotonin reuptake inhibitors (SSRI) include Celexa(r), Paxil(r), Prozac(r), and Zoloft(r). The Food and Drug Administration has approved only Prozac(r) for treating pediatric depression. The FDA has not approved Celexa(r), Paxil(r), and Zoloft(r) for use in patients under 18 years of age. Effexor(r), which is a serotonin and norepinephrine reuptake inhibitor (SNRI), is also not FDA-approved for use in children and adolescents.

FDA's Public Health Advisory on Use of Antidepressants in Children and Adolescents

In June 2003, Great Britain noted a possible increased risk of suicide in children and adolescents taking paroxetine (Paxil(r)). British authorities stopped doctors from prescribing paroxetine for children and adolescents. In March 2004, the FDA issued a Public Health Advisory and directed drug manufacturers to include a warning on the package insert of SSRI antidepressants. The insert should recommend close observation of children and adolescents for increased suicidal tendencies while taking SSRIs. The FDA concluded that there was an increased risk of suicidal thinking and behavior of between 2 and 3 children and adolescents per 100 taking SSRI medications. In October 2004, the FDA directed antidepressant manufacturers to include a so-called "black box" warning on their products advising of the risk of suicide among pediatric and adolescent users of the drugs.

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