Selective serotonin reuptake inhibitors, or SSRIs, are among the most commonly prescribed antidepressants. These drugs are not generally used in adolescents and young adults as several studies have suggested that SSRIs increase the risk of suicidal ideation in these age groups, but not in adults. SSRIs are also believed by some to cause violent behavior, particularly in adolescents and young adults, although the data on this is much more inconclusive. Therefore, one group of researchers in Sweden designed a study to try and determine a possible correlation between SSRI use and violence in adolescents. The researchers used records available from the Swedish Prescribed Drug Register to identify 856,493 patients over the age of 15 who had been prescribed SSRIs in the period between January 1, 2006 and December 31, 2009. The researchers then examined the arrest records of these patients and compared individual patient records when they were on SSRI treatment to when they were not on an SSRI treatment.
Of the entire patient population studied, 9.9% were between the ages of 15 and 24, and these individuals were considered adolescents or young adults. Upon examining the arrest and conviction records of this population, it was determined that this group was more likely to be convicted of a violent crime while on SSRI treatment, although only low doses of SSRIs produced this result. Patients in this age group on moderate or high doses of SSRIs and patients in other age groups on any dose of SSRI did not show a significant increase in violent crime. Within the 15 to 24 age group, the use of medications that could serve as an alternative to SSRIs, such as venlafaxine, was also associated with an increase in violent crime. The study could not determine the cause of this association, and recommended that further studies should be conducted to corroborate their findings.
Given their potential to increase suicidal ideation and possibly the rate of violent crime among adolescents and young adults, is there any case for using SSRIs in adolescents? Would giving a young person large doses of an SSRI really be the most effective treatment option? With this study’s suggestion that other antidepressant treatments may also increase violent behavior in adolescents, is it possible that antidepressant medication as a whole may not be appropriate for adolescents or young adults?