Study: Patients at greatest risk of self-harm right after starting antidepressants

Patients who take antidepressants are at highest risk of harming themselves in the weeks immediately after the drug is prescribed, according to a new analysis of more than 8.4 million electronic health records.

Why it matters: The Food and Drug Administration has warned since 2004 that antidepressants can increase suicidal behavior, but little is known about when the potential threat is greatest, researchers wrote.

• Antidepressants are also estimated to take up to eight weeks to begin working, with side effects common before mood lifts.

The details: The report from the research arm of electronic health records company Epic looked at data between 2017 and 2022 of patients with no history of self-harm or suicide attempts prior to being on antidepressants.

• The analysis doesn't breakdown types of self-harm, which can include but is not limited to attempted suicide.
• The 12-to-17 age group had the highest rate of self-harm at 0.39% and were nearly five times more likely to report a self-harm event in the first few months of being prescribed antidepressants compared to the general population.
• Teen girls, who the CDC in February found are experiencing record levels of sadness and violence, were especially at risk of self-harm.
• Men in the 18-to-24 age group, were slightly more likely to harm themselves than women the same age.
• Active antidepressant prescriptions also doubled between 2017 and 2022, signaling the increased use of depression treatment during the pandemic.

Worth noting: Although researchers did observe an increase in self-harm soon after patients started antidepressants, most first-time self-harm events occurred among patients (69%) who were not on antidepressant medication.

If you or someone you know is having thoughts of suicide, call or text 988 to reach the National Suicide Prevention Lifeline. Ayuda disponible en español.