About a decade after the Food and Drug Administration first warned that antidepressant drugs raise the risk of suicidal thoughts and behaviors in children, new work has found that kids and young adults starting on high doses of antidepressants are at greater risk, especially in the first three months of care.

Among patients 24 and younger, those who started care for depression or anxiety with a higher-than-usual dose of selective serotonin reuptake inhibitor (SSRI) were more than twice as likely to harm themselves intentionally than those whose care began at the customary dose and rose slowly, the study found.

For every 150 such patients treated with high initial doses of SSRIs - marketed under such names as Zoloft, Paxil, Prozac, Celexa, and Lexapro - the study suggests, one more suicide would be attempted. By contrast, young patients starting SSRI therapy at typical doses were at only slightly elevated risk of self-harm, about 12 percent above the level of their depressed peers not taking medication.

The team found no greater risk of suicidal behavior among adults older than 24 who started care at larger initial doses.

For Prozac, a standard dose would be 10 milligrams daily for the first week, rising to 20 milligrams for the next three weeks, before any increased dose. - Los Angeles Times