Studies have shown that children and adolescents beginning to use antidepressant agents may have increased risk of suicidal thoughts and behaviors, but variations in risk among individual medications are unknown. A new study, “Comparative Safety of Antidepressant Agents for Children and Adolescents Regarding Suicidal Acts,” published in the May issue of Pediatrics (published online April 12), compared various selective serotonin reuptake inhibitors (SSRI) antidepressant medications and found no significant differences among them in the risk of suicide attempts or suicides. (Monoamine oxidase inhibitors were not investigated because of the small number of exposed subjects.)

A total of 20,906 children between the ages of 10 to 18 years of age with a diagnosis of depression were observed over a 9-year period. During the first year of use, study authors identified 266 attempted and 3 completed suicides, but no meaningful differences between SSRI antidepressant agents. This analysis supports the decision of the Food and Drug Administration to include ALL antidepressants in the black box warning regarding increased suicide risk for children and adolescents after initiation of antidepressant medication use.

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org.