There is reason to suspect that higher dosages of a certain type of antidepressant has the potential to increase the risk of suicide in younger persons, according to a new study. Published in JAMA Internal Medicine on April 28, the study concluded that higher dosages of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) could bring about an increase in the suicide rates of children, teens and young adults seeking treatment for depression.

There has been concern regarding whether or not SSRIs have this effect on suicidal tendencies in youth for many years. SSRIs have had a black box warning on their labels since 2004, when the FDA released a report that showed the rate of suicide among teens and children nearly doubled with the use of SSRIs, as compared to a placebo. Since 2007, this warning has extended to young adults under the age of 25.

Other research from 2007 indicated that suicide rates continued to climb, even though SSRIs were being prescribed to children and teens 22 percent less often. That study concluded that SSRIs seemed to have been helping reduce suicide occurrences, not elevate them. A review of research literature from that same year came to a similar conclusion and stated that there was more to gain from the use of SSRIs than there were risks.

This latest study approached the issue from a new angle and examined the relationship between elevated doses and suicidal behavior. Researchers examined data from 162,000 patients who received a prescription for an SSRI to treat depression from 1998 to 2010. The patients ranged in age from 10 through 64 years. The study focused on prescriptions for three major drugs, Prozac, Zoloft and Celexa. Each medication has a recommended dosage of 20 mg, 50 mg, and 20 mg, per day, respectively.

After analyzing the data, a clear trend was found among the 18 percent who had been prescribed higher than recommended dosages of the drug. Those under 24 years of age were twice as likely to harm themselves within a year of beginning treatment, the highest rate of which occurred within 90 days of starting the SSRI.

When controlling for age, history of depression, anxiety and suicide attempts, the pattern stood firm as a youth specific phenomena. While researchers do not deny that other factors could influence the rates of suicide among younger populations, they do urge doctors to initiate treatment at lower dosages for young adults and minors.