Related Experiment Video
Updated: Jul 1, 2025
04:29
Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression
Published on: January 7, 2019
28.6K
Suicide, Stimulants, and Selective Serotonin Reuptake Inhibitors: A Retrospective Chart Review
Reena Thomas1, Austin Sellers2,3,4, Jamie L Fierstein3,5
1Department of Child and Adolescent Psychiatry, RĀZ MINDS, Tampa, Florida, USA.
Journal of Child and Adolescent Psychopharmacology
|March 14, 2024
Summary
Selective serotonin reuptake inhibitors (SSRIs) combined with stimulants did not significantly increase suicide risk in youth. Depression diagnosis was a stronger predictor of suicidal thoughts and behaviors (STB) in this population.
Area of Science:
- Child and Adolescent Psychiatry
- Pharmacology
- Mental Health Research
Background:
- Selective serotonin reuptake inhibitors (SSRIs) are linked to increased suicide risk in youth.
- The combined effect of SSRIs and stimulants on suicide risk in pediatric populations is not well understood.
Purpose of the Study:
- To investigate the association between combined SSRI and stimulant use and suicidal thoughts and behaviors (STB) in children and adolescents.
- To determine if other factors, such as depression, influence this relationship.
Main Methods:
- Retrospective cohort study at a pediatric psychiatric clinic (2017-2020).
- Included 349 patients aged 6-21 prescribed stimulants or stimulants plus SSRIs.
- Logistic regression analyzed the association between medication and STB, adjusting for covariates.
Main Results:
- The prevalence of STB was 5.7% in the study cohort.
- Unadjusted analysis showed a higher risk of STB with combined SSRI and stimulant use.
- After adjusting for age, sex, anxiety, and depression, the association between combined medication and STB was attenuated (OR: 1.3).
- Depression diagnosis was significantly associated with increased STB (OR: 3.6).
Conclusions:
- Combination therapy with SSRIs and stimulants did not show a significant independent association with increased STB in youth when adjusted for key factors.
- Depression emerged as a significant risk factor for STB in this patient group.
- Further prospective research is needed to clarify the relationship between combination pharmacotherapy and suicide risk in pediatric populations.
Related Concept Videos
01:28Antidepressant Drugs: Tricyclics, SSRIs, and SNRIs
384
Tricyclic Antidepressants (TCAs), including Desipramine (Norpramin), Imipramine (Tofranil), Clomipramine (Anafranil), and Amitriptyline (Elavil), inhibit serotonin and norepinephrine reuptake and also block other receptors. They are used for depression, pain conditions, and insomnia. Common adverse effects include anticholinergic effects, sedation, orthostatic hypotension, and weight gain. They have a narrow therapeutic window and so require plasma-level monitoring. Abrupt discontinuation can...
384
01:23Antidepressant Drugs: MAOIs and Other Agents
228
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
228
01:25Antidepressant Drugs: Overview
477
Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
477
01:28Drug Therapy
43
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
43
01:30Electroconvulsive Therapy
39
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
39
01:21Drugs Affecting Neurotransmitter Release or Uptake
1.1K
Certain drugs can affect how neurotransmitters called catecholamines, are released or taken back up in the adrenergic neuron. They can have different effects on the body's sympathetic transmission. Reserpine, a natural compound found in the Rauwolfia shrub, blocks a transporter called vesicular monoamine transporter (VMAT), which leads to a buildup of catecholamines in the cell and reduces sympathetic transmission. Another drug called guanethidine works in multiple ways, including blocking...
1.1K