Data on Antidepressants and Suicide4
August 8, 2015
Welcome back for the final installment.
This post will briefly summarize the key points, from Parts 1, 2, and 3, before making some concluding remarks about working with Teens, and understanding Depression.
The data indicates prior to the use of Antidepressant medications for Children and Adolescents, the Suicide Rate was increasing.
Once medications were prescribed, Suicide Rates went down.
When the FDA placed a Black Box Warning on SSRI’s, the prescribing rates went down, but the Suicide Rate for Children, Adolescents and Young Adults went up.
Over time, prescribing rates have returned to appropriate levels, and the Suicide Rate has decreased, very likely as a result.
The data indicates that there is a 4% chance of Suicidal Ideation occurring, or worsening, even leading to suicide attempts, while taking Antidepressant Medications.
There is a 40-60% chance the Antidepressant medication will treat the underlying Depression.
Fluoxetine (Prozac), was found to have the same chance of increasing Suicidal Ideation and Attempts, as a Sugar Pill.
Not treating Depressed Children and Adolescents with Antidepressants, between 2003-2004, resulted in a Suicide Rate higher than the previous 36 years.
The best treatment possible, is Family Support, Cognitive Behavioral Therapy (CBT), along with Antidepressant Medication (TADS Study).
When working with any Teenager with Depression, it is important to form a strong relationship, within the context of therapy.
This entails talking a lot, at times, at others, it means respecting shared silence.
It means being curious about the Adolescent’s life, before, and during their Depression.
It also means becoming more comfortable, talking about uncomfortable things.
If you are working with Teens, ACCEPTANCE is a necessary ingredient.
If you are able to form a trusting bond, it allows the Teenager to be honest about their problems and understand healthy solutions.
It is always a good plan, to form a Safety Plan, with a Depressed Teen, in case they ever develop thoughts about Suicide or Self Harm.
It is much harder to plan in the middle of a crisis.
The symptoms of Depression are much more qualitative than other illnesses.
They can fluctuate, depending on social stresses, or school assignments.
There is no blood test to determine if things are getting better or getting worse.
You can’t take someone’s emotional temperature, to see how they are doing.
Not even with a Mood Ring.
Depression is more qualitative because the brain and mind are intricately woven together, in an electrical tango.
They take turns leading, in the dance of life, in a much more direct way, compared to the brain and armpit.
It is your brain that takes over when your very survival is on the line, ignoring the mind as it takes to flight, or starts to fight.
It is your mind that helps the brain when the chips are down, and reminds it that there are many hands left to play.
Surely, these 2 parts of you are best friends, in a way the armpit, will never really understand.
The only way your armpit can cheer you up, is if someone tickles it.
But the mind can heal the brain, by carefully choosing nourishing thoughts.
A positive cognitive diet, of pleasurable notions and activities, actually physically changes the brain, and can treat Depression.
And many people, in a Depressed Child or Teens life, can help too.
It is the job of great family, loving friends and helpful caregivers, to alleviate stress by helping where it is possible, and ensuring the Teenager is part of a Community, of love, and support.
These ingredients are the best medicine for fighting Depression, and living life in general.
I hope you enjoyed this 4 part series.
Simon Trepel, MD
Simon Trepel, MD FRCPC, is a practicing Child and Adolescent Psychiatrist, in Winnipeg, Canada. He is an Assistant Professor, at the University Of Manitoba, in the Faculty of Medicine, and the Co-founder of the GDAAY Clinic. He is, more importantly, the proud Father of 2 beautiful Daughters. He writes in his spare time about things he knows something about, and occasionally about things he doesn’t; like Yoga, and Italian flavored coffees. He was not referring to coffee that tastes like an Italian person.
Check out his Blog, called Simon Says Psych Stuff, at