Antidepressant Suicide Warnings May Have Increased Attempts: Study

New research suggests that a black box warning warning added to antidepressant drugs about the risk of suicidal thoughts among teens and children may have actually had a negative effect, indicating that the number of suicide attempts associated with the medications increased after the warnings.

In October 2014, the FDA approved an antidepressant black box warning, indicating prominently on the drug label that use of the medications may increase the risk of suicidal thoughts among young people. While the overall risk was small, health regulators determined that warnings may help doctors, patients and parents recognize the signs and reduce the number of suicide attempts.

According to a study published this week by the British Medical Journal, researchers indicate that since the warnings were added, suicide attempts by antidepressant overdose actually increased more than 22% in children and teens.

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Researchers from the Harvard Pilgrim Health Care Institute in Boston analyzed data from 11 healthcare organizations, which provide care for nearly 10 million people in 12 states.

The team, headed by Stephen Soumerai, found suicide attempts increased 22% among adolescents and 34% among young adults. The increase resulted in two more poisonings per 100,000 adolescents and four more per 100,000 adults.

Other studies have suggested that since the imposition of the black box warning and the media attention that followed, antidepressant use has decreased by 31% among adolescents. Use among young adults decreased 24% and 15% among adults.

Researchers said the number of adolescents and young adults receiving medical care for overdosing on antidepressants also increased after the black box was issued. In addition, the number of people being diagnosed with depression declined after the warning.

In spite of the rise in attempts, there was no change in the number of completed suicides, which researchers say is actually quite rare. The increase in attempted suicides continued until 2010.

Conversely, the decline in antidepressant use continued through 2009. A small increase was shown in 2010, but the amount has not increased much since then.

Researchers attribute this to the media attention surrounding the FDA warning, saying it may have changed prescribing habits for the long-term. Its possible doctors avoided prescribing antidepressants after the media reports, resulting in depression in some patients going untreated.

The FDA later amended the warning, advising physicians to consider the risks of prescribing the medication and the risks involved with not prescribing the medication. In order to determine the best possible choice for the patient.

Doctors are also advised to monitor patients who are thinking of committing suicide and treat them as needed. Approximately seven percent of Americans have depression, according to the U.S. Centers for Disease Control and Prevention.


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