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National Institutes of Health

Science Update
November 13, 2006

New NIMH Research Strives to Understand How Antidepressants May Be Associated with Suicidal Thoughts and Actions

The National Institute of Mental Health (NIMH), part of the National Institutes of Health, is funding five new research projects that will shed light on antidepressant medications, notably selective serotonin reuptake inhibitors (SSRIs), and their association with suicidal thoughts and actions (suicidality).

Studies have shown that most individuals suffering from moderate and severe depression, even those with suicidal thoughts, can substantially benefit from antidepressant medication treatment. However, use of SSRIs in children and adolescents has become controversial. In 2005, the U.S. Food and Drug Administration (FDA) adopted a "black box" warning — the most serious type of warning in prescription drug labeling — for all SSRIs. The notice alerts doctors and patients of the potential for SSRIs to prompt suicidal thinking in children and adolescents, and urges diligent clinical monitoring of individuals of all ages taking the medications. This can be particularly challenging because it is difficult for patients, their family members and practitioners to determine whether suicidal thoughts may be related to the depression, the medication, or both.

"These new, multi-year projects will clarify the connection between SSRI use and suicidality," said NIMH Director Thomas Insel, M.D. "They will help determine why and how SSRIs may trigger suicidal thinking and behavior in some people but not others, and may lead to new tools that will help us screen for those who are most vulnerable," he added.

The projects are listed below.

In addition to these new projects, NIMH is currently funding other studies that aim to find the best treatments for individuals suffering from depression, and reduce or prevent suicidal behavior. Studies focused on youth depression and suicidal behavior include the Treatment for Adolescents with Depression study, the Treatment of SSRI-Resistant Depression in Adolescents, and the Treatment of Adolescent Suicide Attempters.