In 2004, the Federal Drug Administration (FDA) issued a warning stating that antidepressant drugs may cause increased risks of suicidal behavior, particularly in children and adolescents. Although most antidepressant medications take about two weeks to improve mood, they affect other symptoms of depression, such as feeling fatigued, in less time. Therefore, the patient who was too tired or mentally overwhelmed to plan and enact a suicide attempt suddenly finds themselves feeling more energetic, but still very depressed. According to research in the Journal of American Medical Association published in 2004, the risk increases between the first and ninth days after starting antidepressant medication. Therefore, patients who may have difficulty inhibiting impulsive or emotionally driven behavior, are most safely prescribed medication when they are also being treated and monitored regularly in therapy.
Effexor and Effexor XR
The antidepressant medication Effexor, generic name venlafaxine, is considered a selective serotonin norepinephrine reuptake inhibitor (SNRI). According to the "Clinical Handbook of Psychotropic Drugs, 15th edition" (2005), SNRI medications are not indicated for children and adolescents, and Effexor, in particular, can cause an increase in hostility and suicidal ideation. This finding has been replicated in research published in "Nature" in 2008.
Remeron
Remeron is a noradrenergic/specific serotonergic antidepressant (NaSSA) medication. The generic name of Remeron is mirtazapine and it is considered a tetracyclic agent. "The Clinical Handbook of Psychotropic Disorders" issues a cautioning statement in relation to prescribing remeron or any other NaSSA medication to patients under 18 years old due to reported episodes of self-harm and suicidal thinking.
Paxil
Paxil is generically known as paroxetine and is a selective serotonin reuptake inhibitor (SSRI) antidepressant medication. According to the FDA, most SSRI medications run the risk of increasing suicidal thoughts in children and teens with major depressive disorder in the first month or two after being prescribed. Despite this, SSRI medications are still thought to be safer for minors than other types of antidepressant medication. "The Clinical Handbook of Psychotropic Drugs" indicates that of the SSRI drugs, children taking Paxil had 1.5 to 3.2 times the number of episodes of self-harm or suicidal behavior compared to children on a placebo drug. Fluoxetine, or Prozac seems to be the safest SSRI antidepressant medication for patients under 18 years old, and according to a 2005 article in "Health News," Prozac has been approved by the FDA for use with children with major depressive disorder.
References
- "Nature"; The molecular neurobiology of depression; Vaishnav Krishnan & Eric J. Nestler; 2008
- "Journal of the American Medical Association"; Antidepressants and the Risk of Suicidal Behaviors; Hershel Jick et. al.; 2004
- "Health News"; FDA Issues Second Warning: Antidepressants May Increase Suicide Risk; July 2005
- "Clinical Handbook of Psychotropic Drugs, 15th Edition"; Bezchlibnyk-Butler and Jeffries (eds.); Antidepressants; 2005.
