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High Doses of Antidepressants Tied to Increase Risk of Self-Harm for the Youth

Update Date: Apr 28, 2014 04:01 PM EDT
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Depression can be a highly debilitating mental disease. Depressed patients do not enjoy life and everyday activities, which can lead to suicidal thoughts. In order to treat the mental illness, patients get antidepressants and/or therapy. However, according to a new study, the doses of the antidepressants prescribed can either negatively or positively affect children and young adult patients. The researchers found that children and young patients who receive higher doses of antidepressants are more likely to inflict self-harm.

In a new study headed by Matthew Miller, M.D., Sc.D., of the Harvard School of Public Health in Boston, MA, the researchers analyzed data on 162,625 people between the ages of 10 and 64. The participants were all clinically depressed and were taking antidepressant medications from 1998 to 2010. The doses ranged from average to high.

The researchers found a link between high doses of antidepressants and suicidal behavior, described as deliberate self harm, for patients who were aged 24 or younger. The researchers reported that patients prescribed higher doses of antidepressants were two times more likely to have suicidal behavior in comparison to patients who were prescribed average doses of antidepressants. When the researchers looked at the incidence rate of suicidal behavior in the high-dose group, they found that there was one additional deliberate self-harm event per every 150 patients. The team did not find a relationship between suicidal behavior and antidepressant doses in patients between 25 and 64-years-old. The researchers also clarified that they did not find a link between doses of antidepressants and suicide risk.

"Considered in light of recent meta-analyses concluding that the efficacy of antidepressant therapy for youth seems to be modest, and separate evidence that dose is generally unrelated to the therapeutic efficacy of antidepressants, our findings offer clinicians an additional incentive to avoid initiating pharmacotherapy at high-therapeutic doses and to monitor all patients starting antidepressants, especially youth, for several months and regardless of history of DSH," the authors wrote.

The study was published in JAMA.

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