Do Antidepressant Drugs Help to Reduce Youth Suicide Rates?

In the article “Youth Suicide” written by David Hosansky, due attention is paid to the issue of the increased suicide rates, its causes and consequences, as well as positive trends to reduce suicide rates. According to statistical data, “in recent years, about 2,800 young people between 10 and 21 have killed themselves annually” (Hosansky 127). The increased suicide rates are found among white males and minority groups like Native American and Native Alaskans. As a rule, young people at risk of suicide suffer from serious emotional problems. Mental health professionals consider that physiological factors play an important role in identification of the key causes of suicide. As a rule, there are some chemical imbalances that occur in the brain and that can cause depressive disorders and suicidal feelings. The issue of the increased suicide rate has become an acute one which requires prompt solutions. Suicide is a real public health problem that is perceived as tragic at any age. This fact means that youth, adults and the elderly commit suicides, although the problem is clearly explained if it concerns the elderly who suffer from serious life threatening diseases. The problem should be addressed by the government through development and implementation of the proper strategies aimed at preventing “the loss of life and the suffering suicide causes” (Hosansky 127). The recognition of suicide warning signs allows identifying suicidal youngsters. In order to achieve this goal, it is possible to use school programs aimed at screening and counselling students with emotional problems (e.g. depression), as well as suicide prevention plans across the country. Recent studies conducted by researchers from Europe show that there is a link between the use of antidepressants and reduced suicide rates. However, British health authorities “warned against prescribing most of the newer antidepressant drugs to children” because of the adverse side effects, which can lead to different forms of self-injury or suicidal thoughts (Hosansky 137). There is much evidence that the antidepressants called SSRIs (selective serotonin reuptake inhibitors) can reduce youth suicide rates, although this issue is still debatable in the academic literature.

As a matter of fact, the key issue while considering the use of SSRIs in the treatment of youth with depressive disorders is “do antidepressants work well”? Exploring this issue with the goal to find the proper answer requires thorough consideration of the evidence. It is important to interpret the results of studies, placing emphasis on the patient outcomes, the clinical significance of the effects of treatment methods, and other research findings of internal and external validity. There are many academic sources that provide research studies aimed at determining ultimately if youth suicide rates are increasing as a result of declined SSRI antidepressant prescription rates. These finding can be used as the key priority in developing effective youth suicide prevention strategies at the national level and global level.

In fact, researchers from the Center for Health Statistics, University of Illinois at Chicago, Robert D. Gibbons and colleagues, found that “after U.S. and European regulatory agencies issued warnings about a possible suicide risk with antidepressant use in pediatric patients, these decreases were associated with increases in suicide rates in children and adolescents” (1356). This fact means that the concerns and views regarding the effectiveness of antidepressants, such as SSRIs, are contradictory as many researchers are unsure that SSRIs can help to decrease the risk of suicide in youths suffering from mood disorders. 

As a matter of fact, a team of Italian researchers from the Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, including Corrado Barbui, Eleonora Esposito and Andrea Cipriani, assumes that there is “the association between exposure to SSRIs and risk of suicide completion or attempt” (291). In their study, a group of researchers provided a systematic review of recently initiated observational studies on the selected issue. They explored the completed and attempted suicide in depressed youths exposed to SSRI antidepressants and compared this data with the young people who did not take antidepressants to assess the overall risk of youth suicide. They found that the majority of observational studies tend to demonstrate the association between the use of SSRIs and reduction of risk of suicide in young people with depressive disorders. In few cases, adolescents’ exposure to SSRIs may lead to the insignificant increase of suicidality (Barbui et al. 296).

Moreover, a group of Australian researchers, including Sarah E. Hetrick and colleagues, argue that the prevalence of depressive disorders among young people should be considered by health care providers to ensure effective treatment. If depressive disorders remain untreated or ineffectively treated, young people are at risk of suicidal thoughts. According to researchers, “the use of antidepressants in the management of depression in children and adolescents is contentious”(Hetrick et al. 53).The fact that SSRIs had been widely accepted in the field of treatment of pediatric depression means that there were many positive health outcomes. Multiple warnings regarding the effectiveness of SSRIs were influential because they resulted in changes of the trials performed by government regulatory agencies. It had been found that “only fluoxetine should be recommended for use in children and adolescents with depressive disorder” (Hetrick et al. 53). However, recent studies suggest that pessimistic views on the effectiveness of treatment methods contribute to the so-called “reluctance on the part of patients to seek help” (Hetrick et al. 53). Besides, clinicians demonstrate reluctance in making depressive disorder diagnoses which is associated with the widely accepted uncertainty regarding the use of antidepressants in treatment of youth. Research findings show that SSRIs can evoke clinical improvement in young people with depression disorders to prevent suicidal thoughts (Hetrick et al. 53).

Furthermore, a group of specialists in Psychiatry, including Michael Dudley, Robert Goldney and Dusan Hadzi-Pavlovic, conducted a study aimed at examining the association between adolescents dying by suicide and their usage of SSRI antidepressants. Researchers were focused on observational research studies, which involved the cases of individual adolescent suicides. The results showed that “nine of 574 young people (1.6%) who died by suicide had had recent exposure to SSRIs” (Dudley et al. 242). Hence, in their study, researchers state that the shortage of the use of SSRI antidepressants prior to youth suicide does not support the assertion that SSRI usage is associated with the increased suicide rates in young people. In other words, most youngsters dying by suicide did not experience the potential advantage of antidepressants at the time of their deaths. This research finding should be considered by clinicians allowing them to prescribe SSRI antidepressants for young people with moderate to severe forms of depression disorders (Dudley et al. 245).

Actually, the research findings provided by Wayne D. Hall and Jayne Lucke support the above mentioned results. Researchers reviewed much important evidence on the effects of SSRI antidepressants in youths. The recent meta-analyses found the evidence that SSRIs can “increase suicidal ideation early in treatment compared with placebo” (Hall & Lucke 941). However, many observational studies demonstrated the increased risk of self-injury within the first nine days of antidepressant prescription. At the same time, ecological studies conducted in developed countries identified “either that suicide rates have declined as SSRI use has increased, or have found no relationship between suicide rates and increased SSRI use” (Hall & Lucke 941). Hence, on the one hand, SSRI antidepressant drugs usage leads to the increased suicide ideation if compared with placebo usage, but on the other hand, SSRI antidepressants usage does not increase suicide risk if compared with the use of other antidepressants. All in all, “if SSRIs increase suicide risk in some patients, the number of additional deaths is very small because ecological studies have generally found that suicide mortality has declined (or at least not increased) as SSRI use has increased” (Hall & Lucke 941).

Undoubtedly, the effects of the warnings issued by the regulatory bodies across the world regarding prescribing antidepressants to children and adolescents with depressive disorders are significant. These warnings might have not only the desired effects on prescribing patterns and further patient outcomes, but also they might have unpremeditated health consequences on the quality of care provision, delivery of health care services and, finally, patient outcomes. Currently, researchers believe that health warnings do not result in unpredicted harmful effects, although there was “significant decrease in the rate of physician visits because of anxiety disorders among young adults after the warning” (Katz et al. 1005). Besides, researchers found that there was a significant increase in the rate of completed suicide (25%) among children and adolescents following the warnings (Katz et al. 1005). This fact means that the warning did not affect antidepressant prescription rates among youngsters with anxiety disorders, excluding reduction of the prescription of SSRIs (Katz et al. 1005). This finding is similar to the above mentioned findings.

Hence, based on the information taken from the article “Youth Suicide” and other academic sources, there is much evidence that antidepressant drugs do help to reduce youth suicide rates. The decision to issue the public health warnings regarding the adverse side effects of antidepressants and decrease SSRI prescription rates for youth was wrong. More SSRI prescriptions lead to considerable reduction of suicide rates in children and adolescents, ensuring “antidepressant efficacy, treatment compliance, better quality mental health care, and low toxicity in the event of a suicide attempt by overdose” (Gibbons et al. 1898). The national youth suicide prevention strategies should be based on these findings to achieve positive outcomes in identification of the proper treatment for children and adolescents with depressive disorders.

Conclusion

Thus, it is necessary to conclude that youth suicide is an acute public health problem that can be solved through the adoption of the proper strategies. One of them is to increase antidepressant medication prescription which allows reducing suicide rate in children and adolescents. It is necessary to recognize that young suicide is one of the leading causes of death the United States and other countries because of the lack of joint actions to prevent suicidal thoughts in depressed youngsters by means of antidepressants like SSRIs. Hence, detection of depressive disorders in young people and the proper management allow achieving positive outcomes through the interventions of minimal risk. All in all, the increased rate of suicide among youngsters in the period following the warning can be viewed as a serious concern for the reason of its coincidence with a decreased rate of visits performed by physicians for providing the treatment of depressive and anxiety disorders in children and adolescents. Nevertheless, there is much evidence that the contradiction is still present in the academic literature, highlighting the negative effects of antidepressant drugs on youth. Generally speaking, current antidepressant drugs do help to reduce youth suicide rates, especially SSRI antidepressants which are considered to be safer and more reliable than previous forms of antidepressant drugs.

Works Cited

Barbui, C., Esposito, E. & Cipriani, A.“Selective serotonin reuptake inhibitors and risk of suicide:a systematic review of observational studies,” CMAJ,180.3(2009):291-297.

Dudley, M., Goldney, R., Hadzi-Pavlovic, D.“Are adolescents dying by suicide taking SSRI antidepressants? A review of observational studies,” Australasian Psychiatry,18.3(2010):242-245.

Gibbons, R. D., Brown, C. H., Hur, K. et al.“Early Evidence on the Effects of Regulators’ Suicidality Warnings on SSRI Prescriptions and Suicide in Children and Adolescents,”American Journal of Psychiatry,164(2007):1356–1363.

Gibbons, R. D., Hur, K., Bhaumik, D. K., Mann, J. J. “The Relationship between Antidepressant Prescription Rates and Rate of Early Adolescent Suicide,”American Journal of Psychiatry,163(2006):1898–1904.

Hall, W. D. & Lucke, J. “How have the selective serotonin reuptake inhibitor antidepressants affected suicide mortality?”Australian and New Zealand Journal of Psychiatry,40.11-12(2009):941-950.

Hetrick, S. E., McKenzie, J. E., Merry, S. N.“The use of SSRIs in children and adolescents,”Current Opinion in Psychiatry,23.1(2010):53-57.

Hosansky, David. “Youth Suicide,”The CQ Researcher,14.6(2004):127-144.

Katz, L. Y., Kozyrskyj, A. L., Prior, H. J., Enns, M. W., Cox, B. J., Sareen, J.“Effect of regulatory warnings on antidepressant prescription rates, use of health services and outcomes among children, adolescents and young adults,”CMAJ,178.8(2008):1005-1011.

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[Accessed: June 2, 2020]

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