Background: Concern exists that antidepressants can cause suicidality in youths with depression.
Aims: To determine the pooled risk of self-harm and suicidal behaviour from randomised trials of newer antidepressants.
Method: A meta-analysis was carried out to calculate odds ratios for the combined data.
Results: Self-harm or suicide-related events occurred in 71 of 1487 (4.8%) of depressed youths treated with antidepressants v. 38 of 1254 (3.0%) of those given placebo (fixed effects odds ratio 1.70, 95% CI 1.13-2.54, P=0.01). There was a trend for individual suicidal thoughts, attempts and self-harm to occur more often in youths taking antidepressants than in those given placebo, but none of these differences was statistically significant.
Conclusions: Antidepressants may cause a small short-term risk of self-harm or suicidal events in children and adolescents with major depressive disorder.