Antidepressants and Suicide: 10 Things Parents Must Know.

1. SSRIs Are First-Line for Moderate-to-Severe Teen Depression

Fluoxetine, sertraline, and escitalopram have the strongest evidence for lifting mood, restoring sleep, and improving school life.

2. The FDA Warning Flags Thoughts, Not Deaths

Early trials showed a small bump in suicidal thinking (≈4 % vs 2 % on placebo). No teen deaths occurred in those studies.

3. Untreated Depression Is the Bigger Danger

Left alone, major depression raises the odds of a suicide attempt far more than well-monitored SSRI therapy.

4. Most Risk Appears in the First 4 Weeks

Treatment-emergent restlessness or scary thoughts usually surface between days 7 and 28—when we schedule extra check-ins.

5. “Start Low, Go Slow” Cuts Side-Effects

Beginning at a low dose and titrating gradually lowers agitation, insomnia, and anxiety—common triggers for self-harm thoughts.

6. Adding Therapy Boosts Safety & Results

Pairing SSRIs with talk therapy speeds recovery and reduces lingering suicidal ideation.

7. Family Safety Plans Save Lives

We draft a written plan outlining warning signs, coping steps, and 24/7 crisis contacts. Keep it on the fridge and in your teen’s phone.

8. Lifestyle Matters More Than You Think

Poor sleep, vaping, bullying, or family conflict can eclipse medication effects. We tackle these areas at every visit.

9. Never Stop Abruptly—Call Us First

Sudden withdrawal can worsen mood and thoughts. If problems arise, we adjust the dose or switch medications safely.

10. Real-World Data Are Reassuring

Large studies show fewer suicide attempts during months on SSRIs compared with months off—evidence that treatment protects when guided by close monitoring.