Columbia University Medical Center
NewYork-Presbyterian Hospital The University Hospital of Columbia and Cornell
April 1, 2009

Self-harm affects thousands of depressed teenagers each year. A careful meta-analysis of pediatric antidepressant trials by the Food and Drug Administration (FDA) showed a higher rate of spontaneously reported suicidal behaviors in adolescents randomly assigned to antidepressants versus placebo. The publicity about this relationship and the subsequent FDA black box warning was followed by a decrease in antidepressant use (1) and a possible increase in adolescent suicides. Whether the increase is real and sustained is still unclear (2

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