Children and young adults who start taking antidepressants at high doses are more likely to think about or attempt suicide than those who start at the doses of antidepressants that are typically prescribed, according to a new study.
Researchers found that young people between ages 10 and 24 who started antidepressant therapy at high doses were twice as likely to attempt or think about suicide over the first 90 days of treatment compared to those who started taking antidepressants at the doses recommended by doctors' guidelines.
This translates into about one additional event of suicidal behavior for every 150 patients who take high doses of antidepressants, the researchers said, writing April 28 in the journal JAMA Internal Medicine.
"There is no evidence that starting at a higher dose is beneficial," said Dr. David Brent, of the University of Pittsburgh, who was not involved in the research, but wrote a commentary about the study also published in the journal.
About 18 percent of the 10- to 24-year-olds in the study were prescribed a higher dose, and although the study doesn'tmake clear why some got a higher dose, there may be differences between the young people in this group and those given the normal doses, Brent noted in his commentary. For example, those given higher doses may not have received average doses of antidepressants in the past and failed to respond.
Among young people between ages 10 to 24, suicide is the third leading cause of death, the CDC reported in January 2014. And there are many more suicide attempts than suicides that are actually completed. Each year, about 157,000 young people between ages 10 and 24 receive medical care for injuries resulting from suicidal behavior at ERs across the United States.
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