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First Published Thursday, 2 April 2009


Teen Depression

Am J Psychiatry 2009 Apr; 166:385



Myrna M. Weissman, PH.D.


Self-harm affects thousands of depressed teenagers each year. A careful meta-analysis of pediatric antidepressant trials by the Food and Drug Administration (FDA) showed a higher rate of spontaneously reported suicidal behaviors in adolescents randomly assigned to antidepressants versus placebo. The publicity about this relationship and the subsequent FDA black box warning was followed by a decrease in antidepressant use and a possible increase in adolescent suicides. Whether the increase is real and sustained is still unclear. Data that can identify who is at risk for an increase in reported self-harm with medication are difficult to find. Standardized systematic assessment of suicidal events in adolescent trials have only recently been developed, and adolescents with a history of self-harm behaviors, the ones with greatest risk, have usually been excluded from clinical trials.


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