A Useful Theory on SSRI-Induced Suicidality in Children and Teenagers

An animal study yields insights into how selective serotonin reuptake inhibitors alter serotonin levels early in treatment and supports slower titration to alleviate increased suicidality in early treatment.

A vexing problem in treating major depression in children is balancing the need to treat suicidal ideation against the suicide risk that increases during early administration of selective serotonin reuptake inhibitors (SSRIs; NEJM JW Psychiatry Sep 2004 and JAMA 2004; 292:338). These investigators (some with a related patent application) reasoned that suicidality is heightened by decreased serotonin (5-HT) availability, due to presynaptic activity of the 5-HT1A autoreceptor (AR) that increases in response to SSRIs' blockade of the 5-HT transporter (5-HTT). Thus, early SSRI treatment produces a hyposerotonergic state, known to cause agitation.

The investigators conducted an animal study focusing on countering AR hyperactivity during the 2 to …

Reviewing Author

Barbara Geller, MD

Disclosures

Nothing to disclose

Barbara Geller, MD

Disclosures

Nothing to disclose

A Useful Theory on SSRI-Induced Suicidality in Children and Teenagers

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Reviewing Author