Archive 1992–2014

Aims. To summarize the current research findings from randomized, placebo-controlled trials, observational epidemiological studies and meta-analyses concerning the relationship between antidepressant treatment and the risk of suicidal behaviors among children, adolescents and young adults.
Review. On the grounds of an analysis of data reported in clinical studies pharmaceutical inspection agencies issued warnings about increased risk of suicidal behaviors in the child and adolescent, and later also young adult populations treated with antidepressants. These reports started a hot debate in psychiatric circles on the effectiveness of antidepressants in the child and adolescent population and on the alleged increase in their suicidal behavior risk. The latter was surprising to many clinicians, and seemed inconsistent with the fact that many antidepressant medications had been proven to prevent relapse of depressive disorders.
Conclusions. The results of randomized, placebo-controlled trials as well as meta-analyses of observational studies indicate that an increased risk of suicidal behaviors during the first few weeks of antidepressant treatment is possible, particularly among children, adolescents, and young adults. Therefore the decision to introduce antidepressant medication should be made individually, possible therapeutic benefits of such treatment should be carefully considered, and antidepressant treatment should be monitored in these age groups in accordance with the recommendations.