Update on antidepressant link with suicide

Reported by Susan Aldridge, PhD, medical journalist

The latest evidence suggests there is a possibility that antidepressants could worsen suicidal behavior.
In recent years, there has been controversy over whether antidepressant drugs are linked with suicide. It's a tricky issue because, of course, depression itself is a risk factor for suicide. How do you know it was the drug and not the illness itself that caused the suicidal behavior?

There are three new studies in the current issue of the British Medical Journal which offer new insights. In the first, those on selective serotonin reuptake inhibitors (SSRIs), which are very widely used, did run a higher risk of suicide attempts than those on placebo. But SSRIs were not linked with a bigger risk of fatal suicide attempts. Nor were they any worse in this respect than other antidepressants.

Another review of 477 clinical trials showed no link between SSRIs and suicide, but a weak link with self harm, And the final study came from the General Practice Research Database in the UK, covering over 146,000 patients taking SSRIs and tricyclic antidepressants. There were no differences in suicidal tendencies between the two groups, although those under 18 on SSRIs were more likely to self harm. The researchers say that monitoring of those on SSRIs is important, especially in the early stages when the therapeutic effects of the drug have not kicked in. And there is still room for more long-term studies of the effects of SSRIs and other antidepressant drugs.

Source
British Medical Journal 19th February 2005 Volume 330 pages 385-393

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