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Suicidal behaviour in youths with depression treated with new-generation antidepressants

Meta-analysis

School of Psychiatry and Behavioural Sciences, University of Manchester

SARAH HADLEY, MSc and CHRISTOPHER ROBERTS, PhD

Biostatistics Group, University of Manchester, Manchester, UK

Correspondence: Dr Bernadka Dubicka, University Department of Child and Adolescent Psychiatry, Royal Manchester Children’s Hospital, Pendlebury, Manchester M27 4HA, UK. Tel: +44 (0)161 727 2401; email: Bernadka.Dubicka{at}manchester.ac.uk

Declaration of interest B.D. and C.R. participated in a National Health Service fluoxetine trial(funded by the Health Technology Assessment Programme).

Background Concern exists that antidepressants can cause suicidality in youths with depression.

Aims To determine the pooled risk of self-harm and suicidal behaviour from randomised trials of newer antidepressants.

Method A meta-analysis was carried out to calculate odds ratios for the combined data.

Results Self-harm or suicide-related events occurred in 71 of 1487 (4.8%) of depressed youths treated with antidepressants v. 38 of 1254 (3.0%) of those given placebo (fixed effects odds ratio 1.70, 95% CI 1.13–2.54, P=0.01). There was a trend for individual suicidal thoughts, attempts and self-harm to occur more often in youths taking antidepressants than in those given placebo, but none of these differences was statistically significant.

Conclusions Antidepressants may cause a small short-term risk of self-harm or suicidal events in children and adolescents with major depressive disorder.

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