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Kids and young adults who start with high doses of antidepressant are at high risk, especially in the first three months of treatment, according to a recent study. 

Around ten years ago, the Food and Drug Administration had first warned that antidepressant medications increased the risk of suicidal thoughts and behaviors in children.

The new study found that among patients 24 and younger, those who started treatment for depression or anxiety with a higher-than-usual dose of selective serotonin reuptake inhibitor, or SSRI, were more than twice as likely to harm themselves intentionally than those whose treatment began at the customary dose and increased gradually. 

According to the study, for every 150 patients treated with high initial doses of SSRIs-antidepressants marketed under such commercial names as Zoloft, Paxil, Prozac, Celexa and Lexapro, one additional suicide would be attempted. Contrastingly, young patients starting SSRI therapy at doses considered normal were at only a bit elevated risk of self-harm. 

The research also noted that there wasn't any increased risk of suicidal behavior among adults older than 24 who started medical treatment of depression or anxiety at larger doses initially. 

The authors acknowledged that they could not discern why younger patients on high initial doses of antidepressant were more likely to try to harm themselves. Although it could have been the dose at which these young patients began their therapy, it is equally plausible that younger patients who are correctly perceived to be in a mental health crisis are more likely to be treated more aggressively, but not more likely to get better with SSRIs, the press release added.

The study has been published in the JAMA Internal Medicine.