Are adolescents dying by suicide taking SSRI antidepressants? A review of observational studies

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.