Antidepressants and suicidal ideation in adolescence: a paradoxical effect.

The past two decades have seen a rapid increase in the number and types of psychopharmacological medications that are available for the treatment of depression in children and adolescents. Parents and adolescents often raise questions as to the potential increase in suicidal ideation associated with the use of primarily selective serotonin reuptake inhibitors (SSRIs). This has been driven in part as a result of media attention that has focused on the Òblack boxÓ warnings regarding increases in suicidal ideation for SSRIs. The current article reviews the status of the literature surrounding suicidal ideation and SSRIs in adolescence. Finally, the article strives to educate the clinician as to the likelihood of suicidal ideation and completions in the context of rates for all adolescents. Findings related to changes in treatment as a result of the U.S. Food and Drug Administration (FDA) black box warning are discussed as well.