Do antidepressants actually cause children to be suicidal? If so, how do we detect it, and what should we do about it? In this article, we’ll give you a brief review of the most recent findings on antidepressant-induced suicidality (AIS) in children and adolescents, and then move on to some practical tips for how to evaluate and prevent this problem.

The issue of emergent suicidal thinking has weighed on us since the 2004 black box warning—amplified by the re-analysis of the now infamous study 329, which found the emergence of previously under-reported suicidal thinking. How do we offer hope for effective use of medication while balancing the potential risks? Dr. Danella Hafeman has made a close study of it all and sheds light on the problem.

When I work with an agitated patient, I start by saying, “Hi, I’m Dr. Fishkind. My job is to keep you safe today.” Your first job should be to take away any possibility that the person thinks you’re dangerous or that you’re there to cause harm. So, start by identifying who you are, what you do, and that you are there to help.

Dear Dr. Aiken: Can you tell us more about hyponatremia? Which medications can cause hyponatremia, who’s at risk, and how we should manage this condition?

Since they already often seem two steps ahead of us, with adolescents it can be really helpful to use direct routes. Be very specific in your questions. For example, don’t just ask, “Do you smoke?” Ask, “Are you using any nicotine products? What are you using in your vape?”

When I think of a child with autism, I want to discover who he is—not just his diagnosis, but how he relates, feels, functions, and learns in the context of family, culture, environment, and education.

It can be challenging to manage chronic pain, even more so when our patients suffer from addiction. We can find ourselves walking a tightrope between the risk of relapse due to the inadequate treatment of pain, and the risk of relapse due to the use of opioid analgesics.