ArticleBMJ (Clinical research ed.)2014
Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study.
Article in BMJ (Clinical research ed.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
81 citing papers in PubMed, 5 syntheses or guidelines pooled it, 231 citations in OpenAlex.
- Pooled it
- New generation antidepressants for depression in children and adolescents: a network meta-analysis.The Cochrane database of systematic reviews · 2021Pooled it
- Interventions for self-harm in children and adolescents.The Cochrane database of systematic reviews · 2021Pooled it
- Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis.The lancet. Psychiatry · 2020Pooled it
- Interventions for self-harm in children and adolescents.The Cochrane database of systematic reviews · 2015Pooled it
- Ketamine as a Bridge Therapy: Reducing Acute Suicidality in Hospital Settings.Healthcare (Basel, Switzerland) · 2026Review
- The use of multidimensional assessment in developmental age: How evaluation of the emotional-autonomic state can facilitate the differential diagnosis in psychopathology. Description of two case studies.Health psychology report · 2026Article
- Assessing the Impact of Antidepressants on Cancer Treatment: A Retrospective Analysis of 14 Antineoplastic Agents.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2025Article
- Establishing the effect of COVID-19 lockdown policy on the utilization of facility-based delivery in Kenya: a multi-method study.BMC health services research · 2025Article
- Retrospective Evaluation of Drug-Drug Interactions With Erlotinib and Gefitinib Use in the Military Health System.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2023Article
- Adverse Effects of Antidepressant Medications and their Management in Children and Adolescents.Pharmacotherapy · 2023Review
- Pharmacologic Approaches to Suicide Prevention.Focus (American Psychiatric Publishing) · 2023Review
- The Impact of Prescribing Monitoring Policy on Drug Use and Expenditures in China: A Multi-center Interrupted Time Series Study.International journal of health policy and management · 2023Article
- The Mediterranean Diet and the Western Diet in Adolescent Depression-Current Reports.Nutrients · 2022Review
- Suicidality and self-injury with selective serotonin reuptake inhibitors in youth: Occurrence, predictors and timing.Acta psychiatrica Scandinavica · 2022Observational
- When Can We Trust Real-World Data To Evaluate New Medical Treatments?Clinical pharmacology and therapeutics · 2022Article
- Media coverage about medical benefits of MDMA and ketamine affects perceived likelihood of engaging in recreational use.Addiction research & theory · 2022Article
- Trends in Ketamine Use, Exposures, and Seizures in the United States up to 2019.American journal of public health · 2021Article
- Assessing the Impact on Health of Pharmacovigilance Activities: Example of Four Safety Signals.Drug safety · 2021Article
- Unpacking the effects of adverse regulatory events: Evidence from pharmaceutical relabeling.Research policy · 2021Article
21 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
17 authors at 9 institutions in 1 country.
Funding
Abstract
objectiveTo investigate if the widely publicized warnings in 2003 from the US Food and Drug Administration about a possible increased risk of suicidality with antidepressant use in young people were associated with changes in antidepressant use, suicide attempts, and completed suicides among young people.
designQuasi-experimental study assessing changes in outcomes after the warnings, controlling for pre-existing trends.
settingAutomated healthcare claims data (2000-10) derived from the virtual data warehouse of 11 health plans in the US Mental Health Research Network.
participantsStudy cohorts included adolescents (around 1.1 million), young adults (around 1.4 million), and adults (around 5 million).
main outcome measuresRates of antidepressant dispensings, psychotropic drug poisonings (a validated proxy for suicide attempts), and completed suicides.
resultsTrends in antidepressant use and poisonings changed abruptly after the warnings. In the second year after the warnings, relative changes in antidepressant use were -31.0% (95% confidence interval -33.0% to -29.0%) among adolescents, -24.3% (-25.4% to -23.2%) among young adults, and -14.5% (-16.0% to -12.9%) among adults. These reflected absolute reductions of 696, 1216, and 1621 dispensings per 100,000 people among adolescents, young adults, and adults, respectively. Simultaneously, there were significant, relative increases in psychotropic drug poisonings in adolescents (21.7%, 95% confidence interval 4.9% to 38.5%) and young adults (33.7%, 26.9% to 40.4%) but not among adults (5.2%, -6.5% to 16.9%). These reflected absolute increases of 2 and 4 poisonings per 100,000 people among adolescents and young adults, respectively (approximately 77 additional poisonings in our cohort of 2.5 million young people). Completed suicides did not change for any age group.
conclusionsSafety warnings about antidepressants and widespread media coverage decreased antidepressant use, and there were simultaneous increases in suicide attempts among young people. It is essential to monitor and reduce possible unintended consequences of FDA warnings and media reporting.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.