Selective serotonin reuptake inhibitors and suicidality in juveniles: Review of the evidence and implications for clinical practice

This article reviews the existing evidence regarding whether selective serotonin reuptake inhibitors increase suicidal behaviors in children and examines the implications of the findings for clinical practice and research. When balanced against the fact that depression in the young is a serious, recurring condition that produces personal suffering and can lead to suicide, the overall weight of the evidence favors pharmacologic treatment over nontreatment in moderate to severe depression. Nevertheless, the need for careful clinical monitoring of suicidality and attention to behavioral activation, manic switching, and medication compliance or withdrawal are clearly warranted