Abstract
Objective: The aim of this study was to examine the association between adolescents who die by suicide and their use of SSRI antidepressants.
Method: We sought all available observational studies of individual adolescent suicides that were population based and which contained individual data on SSRIs at or around the time of death.
Results: From an initial database of 656 studies, we identified and examined six studies. In the latter, nine of 574 young people (1.6%) who died by suicide had had recent exposure to SSRIs.
Conclusion: The rarity of SSRI usage prior to adolescent suicide is not supportive of the assertion that SSRIs are associated with increased suicide in young people. Given the prevalence of depression associated with youth suicide, it favours the conclusion that most adolescents dying by suicide have not had the potential benefit of antidepressants at the time of their deaths. This finding should allow practitioners, with appropriate precautions and as part of a comprehensive management plan, to more confidently prescribe SSRIs for young people with moderate to severe clinical depression.
ACKNOWLEDGEMENTS
The authors are grateful to the Canadian Medical Association for permission to adapt a table originally published in a Letter to the Editor in the Canadian Medical Association Journal on 17 March 2009.
DISCLOSURE
Dr Dudley has not received drug company funding at any time. Professor Goldney has received honoraria, travel grants and research support from a number of pharmaceutical companies. Mr Hadzi-Pavlovic received payment some years ago for a lecture on statistics to registrars, and also was paid for travel and attendance at an international conference a few years ago that was heavily sponsored by European drug companies (though the invitation was via the conference organizers).