Youngsters who take high doses of antidepressants are at risk of suicidal behaviour, a new research warns.
Researchers say that the children and youngsters who start off their antidepressant therapy at more than recommended dosage have more chances of suicidal behavior during the first 90 days of treatment.
For the study, the researchers analyzed data of 162,625 people aged between 10 and 64. All the participants started antidepressant treatment with a selective serotonin reuptake inhibitor at medium or higher than medium dose from 1998 through 2010.
The results showed that the suicidal rate among children and adults below the age of 24 who started antidepressant therapy at high doses was double the rate of patients in a matched group who were prescribed modal doses. But, no suicidal risk was found among the adults aged between 25 and 64 in either group.
It was, however, unclear how the higher doses of selective serotonin reuptake inhibitor treatment increased the risk of suicidal behavior.
"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 deliberate self-harm," Matthew Miller, M.D., Sc.D., of the Harvard School of Public Health, Boston, and colleagues wrote in the study.
"Moreover, while definitive studies on the impact of dose escalation in the face of non-response remain to be done, there are promising studies that suggest in certain subgroups, dose escalation can be of benefit. Finally it should be noted that in this study, there was no pre-exposure to post-exposure increase in suicidal behavior after the initiation of antidepressants in youth treated at the modal dosage," they concluded.
The findings are published in the journal 'JAMA Internal Medicine.'
