EMBARGOED UNTIL: October 13, 2003

NEW STUDY SUGGESTS INCREASED ANTIDEPRESSANT USE MAY REDUCE SUICIDE IN ADOLESCENTS

New findings suggest that there is a relationship between antidepressant use and the rates of suicide in adolescents. In the October issue of the Archives of General Psychiatry Dr. Mark Olfson—a psychiatric researcher at the New York State Psychiatric Institute—and colleagues detail the results of an analysis of 10-19 year olds prescribed antidepressants in nearly 600 geographic regions in the US between 1990 and 2000. They found that regions with increased antidepressant use tended to have decreased suicides. This correlation was especially evident among boys, adolescents age 15 to 19 years of age and in lower income areas.

The researchers found that for every increase of one percent in the use of antidepressants by adolescents, there was a decline of about .25 youth suicides per 100,000 per year. (According to federal statistics, there were approximately 2,400 suicides committed by adolescents in 2000, down from roughly 2,800 in 1990.) It should be noted that the correlation between increased medication use and decreased suicide rate was observed only in the use of the newer SSRIs and not the older tricyclic antidepressants.

Prior to the current study, researchers had looked at broad changes in individual European countries rather than changes across large numbers of regions. Past epidemiological studies and observations of trends had revealed certain findings: (1) that up to one-half of all suicides in young people were committed by those who had depression, (2) that most individuals with depression do not receive mental health treatment and (3) that in recent years there has been a noticeable increase in antidepressant use and a decrease in the suicide rate. However, nothing was known about “how the changes in antidepressant use and suicide rates were related in terms of the geographic regions,” said Dr. Olfson.

“What this study did was provide evidence that the very regions with increases in the use of antidepressants experienced declines in suicide.” Dr. Olfson cautions that one would be overstating the data by making the argument that the decline in suicide was due to the increase in antidepressant use. “At the same time,” he added “it puts a sharper focus on these two large trends and suggest that they’re related.”

One of the study’s limitations is that the researchers did not look at the role of psychotherapy. Though other studies have found that in the period in which these adolescents were studied there was little change in the volume of psychotherapy visits that were made by young people, this type of intervention may partially explain the drop in suicide rates.

How should one look at these findings in the context of current FDA restrictions? ”We’re clearly in a period of some uncertainty about these medications…I think the new study provides additional information that will increase interest in this area and will, hopefully, slow the rush to negative judgment about these medications in the treatment of depressed young people. I hope that it will also increase motivation for research at the patient level to increase our understanding of the appropriate role of antidepressant medications in the treatment of depressed young people,” said Dr. Olfson.

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