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Activity Dates: 04/19/2009 - 04/19/2012

This course is closed. Please look for other available products in CPNP University.

Target Audience

If you are a pharmacist, nurse practitioner or other healthcare professional involved in the comprehensive medication management of psychiatric and/or neurological patients, we invite you to participate in this online course.

Session Summary

Suicide is considered rare in non-depressed individuals but it occurs in between 5 and 15% of those suffering from depression.  The Columbia Suicide Severity Rating Scale (C-SSRS) is recommended for assessing an individual patient’s suicide risk.  Suicide risk factors in children, adolescents and adults include untreated depression, psychosis, access to firearms. Additional factors that increase suicide risk in children and adolescents include maternal depression, witnessing suicide attempts or sexual abuse or experiencing sexual abuse or trauma themselves.  Cyber-bullying is becoming more recognized as a contributing factor to suicide in youth.

In 2004, the FDA applied warnings to antidepressants regarding an increased risk of suicidal thoughts and behaviors in children and adolescents.  In 2007, the FDA revised this warning to inform consumers that untreated depression or other mental illnesses also increase the risk for suicide.  Increased suicidality associated with antidepressant use may be related to increased energy from the antidepressant before the mood is improved or it may be a result of drug-induced activation, impulsivity or a switch from depression to mania or hypomania.

Antidepressant therapy is an effective and safe treatment option for adolescent depression with careful monitoring and counseling. Fluoxetine, sertraline, citalopram and escitalopram all have evidence to support their use as first-line treatments for depression in adolescents.  Results are less robust for pre-pubertal children although fluoxetine is FDA approved down to 8 years old.  Venlafaxine has been demonstrated as an effective treatment option for resistant depression in adolescents.  Cognitive behavioral therapy is also an effective treatment option that may offer a protective “anti-suicide” effect.  Psychosocial interventions are recommended for very young children as well as maintaining a watchful, waiting approach.  

Course Requirements

You will proceed through the following steps to satisfactorily complete this course:

  • Review the full content of the activity and reflect upon its teachings.
  • Complete the post-test at the end of the activity no later than the closing activity date. (login first)
  • Complete the evaluation at the end of the activity. (login first)
  • Receive a passing grade (60%).
  • Provide the necessary details in your profile to ensure correct reporting by CPNP to CPE Monitor. (login first)

This course is provided online at cpnp.org and consists of the speaker audio and slides. A PDF file of the slides is also provided and access is available to participants indefinitely although ACPE credit is available only through the course expiration date.

Participants in this course must complete an examination and achieve a score of 60% or greater. Successful completion of the course also requires the completion of a course evaluation. ACPE statements of credit can be retrieved by participants online at cpnp.org immediately upon successful completion of the course.

Faculty Information and Disclosures

Julie Dopheide, PharmD, BCPP
Steve Stoner, PharmD, BCPP

View biographical information and disclosures

Learning Objectives

  1. Identify risk factors for suicidal behavior and ideation in youth that are associated with depression and antidepressant treatment.  
  2. Compare the clinical outcomes related to suicidality and suicide rates from recent antidepressant trials assessing the effectiveness of depression treatment in children, adolescents, and adults.
  3. Explain the clinical impact on depression treatment and suicide rates before and after the introduction of FDA mandated suicidality warnings.
  4. Design a treatment regimen with monitoring parameters for a child or adolescent with depression that includes nonpharmacologic therapy, antidepressants, and adjunctive agents.

Continuing Education Credit and Disclosures

Activity Dates: 04/19/2009 - 04/19/2012
ACPE Contact Hours: 2.0
ACPE Numbers: 0284-0000-09-003-H01-P, 0284-0000-09-002-H01-P
Nursing Credit Reminder: Note that ACPE credit is accepted for certification renewal.

ACPEThe College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This self-study course provides 2.0 contact hours (0.2 CEUs) of knowledge-based continuing education credit from CPNP approved programming. The ACPE universal program numbers assigned to this course are 0284-0000-09-003-H01-P and 0284-0000-09-002-H01-P (2.0 contact hours).

ACPE approved contact hours are accepted for ANCC Certification Renewal (see pages 5 and 6): At least 50% (37.5 hours) of your 75 continuing education hours must be formally approved continuing education hours. Formally approved continuing education hours meet one or more of the criteria listed below:

  1. Continuing nursing education (CNE) approved for nursing contact hours by an accredited provider or approver of nursing continuing education
  2. Continuing medical education (CME) approved for CME hours
  3. Sponsored by organizations, agencies, or educational institutions accredited or approved by the American Nurses Credentialing Center (ANCC) or the Accreditation Council for Continuing Medical Education (ACCME) or the Accreditation Council for Pharmacy Education (ACPE) or the Commission on Dietetic Registration

Grant Support

This programming was supported in part by grants from Bristol-Myers Squibb, Forest Laboratories, Inc., Lilly, Schering-Plough, Cyberonics, Shire, and Janssen, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. administered by Ortho-McNeil Janssen Scientific Affairs, LLC.

Annual Meeting Grant Supporter

Recertification Education Grant Provider

Supported by an educational grant from Janssen, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc. administered by Ortho-McNeil Janssen Scientific Affairs, LLC.