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Under 25s at risk

Research shows that the risk of suicide in people taking antidepressants is "strongly age-dependent" with those under 25 at greater risk

People aged 25 years old and younger who take antidepressants are at much greater risk of suicide than older adults, research from the US Food and Drug Administration (FDA) has revealed.

FDA scientists Dr Marc Stone, Dr Thomas Laughren and colleagues reviewed data from eight pharma companies and 372 clinical trials involving nearly 100,000 adults. They found that the risk of suicide is "strongly age-dependent" with those under 25 at higher risk, no difference among patients aged between 25 and 64, and lower risks in those aged 65 and older.

Researchers say that the findings published in the British Medical Journal support the FDA's labelling on antidepressant use in people under 25 and show that antidepressant medication can have two distinct effects. It can increase suicidal thoughts and behaviour in those under 25 but provide long-lasting, significant relief from depression and reduce the risk of suicide in older patients. Scientists said that further research is needed to understand the differences and why they occur.

The findings support previous studies and the FDA's age-related warnings on drug labels. European and US regulators first sounded a note of caution about the use of antidepressants in 2003 when clinical trials showed an increased risk of suicidal thoughts and behaviours in patients under 18 years old.

In 2005, the FDA placed a black box warning on the use of all antidepressants in young children and teens to highlight the possible risks associated with these medications. Two years later, the regulator extended the warning to include young adults aged 18-24 years old.

Psychiatrists criticised the move saying that it resulted in people who would have benefited from an effective treatment for depression being too scared to take medication. Studies suggest that the black box warnings resulted in an 8 per cent increase in suicide in young people in 2004, the biggest 12-month rise in 15 years.

13th August 2009

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