Research sheds new light on the rising rates of suicidal behavior among teens.

Patients taking antidepressants are at the greatest risk of self-harm, including suicidal thoughts and actions, in the weeks immediately after first starting on the drugs, a new research study found.  Teens are the age group most at risk in the first few months of being prescribed antidepressants, and teen girls are especially at risk.  With a soaring number of adolescents started on antidepressants in recent years, the study sheds new light on the rising rates of suicidal behavior reported by teens.

The increased risk of suicidal behavior from taking antidepressants is well known, but less was known about when and for whom that risk is greatest. Data scientists at Epic Research analyzed the electronic health records of more than 8 million patients ages 12-90 with no history of self-harm when first prescribed antidepressants and over 1 million patients who self-harmed between 2017 and 2022.

The rate of self-harm for all patients was highest right after starting antidepressants. “Patients are at greatest risk of self-harm events soon after initially being prescribed an antidepressant,” the researchers wrote.

The rate of self-harm events for adolescents ages 12-17 was significantly higher than for other age groups. At its peak in the third week after starting on antidepressants, the rate for teens of 390 self-harm events per 100,000 patients was five times greater than the all-patients rate of 67 per 100,000. The researchers further found that “adolescent females are especially at risk.” The teen rate decreased over subsequent months but remained higher than for other age groups.

Earlier this year, the Centers for Disease Control and Prevention (CDC) reported the results of its survey of high school students’ health-related behavior.  Over the 10-year period from 2011-2021, the percentage of high school students who seriously considered suicide rose from 16% to 22% and students who attempted suicide increased from 8% to 10%.

The rates were higher among female students. In 2021, 30% of girls had serious suicidal thoughts, double the rate of boys, and up nearly 60% over 10 years. Some 13% of girls reported they attempted suicide.
This more prevalent suicidal behavior occurred at the same time the number of teens prescribed antidepressants rose rapidly. From 2011-2020, the number of adolescents ages 13-17 who were prescribed antidepressants increased by 52%, from roughly 1.1 million to more than 1.6 million.

In 2004, the U.S. Food and Drug Administration (FDA) required its most stringent, black box warning on antidepressant packaging to alert consumers and prescribers to the increased risk of suicidal thoughts and behavior for children and adolescents. The action came after drug trials indicated that youth taking antidepressants were almost twice as likely to have suicidal thoughts or suicide attempts as those receiving placebos. The warning was expanded in 2007 to include young adults through age 24.

Critics complained that more suicides were caused by youngsters not treated with antidepressants due to the black box warning. In response, researchers recently re-analyzed clinical trial data and concluded the warning is clearly justified and that the increasing number antidepressant prescriptions is related to more suicide attempts and completed suicides among American children and adolescents.

Antidepressants have also been found to double the risk of suicidal behavior in adults. When healthy adults with no signs of depression were given antidepressants, their risk of suicidality and violence doubled.

In 2020, some 45 million Americans, or roughly one in seven, were taking antidepressants, up from 34 million in 2006. This 32% increase in users parallels the 35% increase in suicides in the U.S. over the same period.

Research has also found no clinically significant difference in measures of depression symptoms between patients treated with antidepressants and those taking placebos, whether over a shorter or longer time frame and regardless of the severity of the patients’ depression.

A landmark 2022 study questioned the prescribing of antidepressants after finding the theoretical reason for taking them – to correct a supposed chemical imbalance in the brain – had no scientific basis.

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

The Citizens Commission on Human Rights (CCHR) recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression or other unwanted mental and behavioral symptoms, which might otherwise be misdiagnosed and incorrectly treated as a psychiatric disorder.