Suicide is one of the major causes of morbidity and mortality amongst children 
and adolescents. In 2004 the Food and Drug Administration (FDA) issued a 
"black-box" warning for antidepressants in children and adolescents, stating 
that these drugs may increase suicidality, a term encompassing both suicidal 
thoughts and behavior, especially in the first few weeks of treatment. The 
warning was extended in 2007 to antidepressants prescribed to adults aged 25 and 
under. The evidence behind this decision stemmed from meta-analyses of 
antidepressant clinical trials that demonstrated a slight increase in 
suicidality in those receiving antidepressants versus those treated with a 
placebo. Due to methods of this pooled data compilation, the relationship 
between antidepressants and suicidality remains controversial. This report 
investigates a case where a 14 year old with major depressive disorder (MDD) 
developed suicidal ideation shortly after being prescribed a selective serotonin 
reuptake inhibitor (SSRI). Investigating the role antidepressants may play in 
suicidality suggests the need to explore the neurobiological mechanisms within 
the serotonin system. This case and its theoretical explanations attempt to 
bridge the gap between neurobiology and pharmacology in order to better 
delineate the etiology of this adverse effect.