OTTAWA - A widely prescribed class of anti-depressants contributes to a two-fold increase in the risk of suicide attempts, say the Canadian authors of the most comprehensive study of its kind.
The findings, published in the most recent issue of the British Medical Journal, have significant implications because of the widespread use selective serotonin reuptake inhibitors (SSRIs).
Scientists at the Ottawa Health Research Institute analyzed more than 700 clinical trials involving almost 90,000 patients taking SSRIs, which include drugs sold under the name brands Prozac, Cipramil and Zoloft.
The Ottawa study compared the reported number of suicide attempts by patients on the drugs to the number of attempts by patients taking a placebo.
The risk of suicide is somewhat expected with depression, but the study found that the drugs contributed to an increased risk in patients suffering from other conditions. Doctors also prescribe SSRIs to treat anxiety, post-traumatic stress disorder and social phobia.
"The very interesting thing is it's occurring in non-depressed individuals," said Dr. Paul Hebert, co-author of the study. "We're seeing it in some diseases where suicide is unexpected, for example in panic disorder."
The study's authors say the risk could be higher than their results show because the published clinical trials they examined have limitations.
Most of the trials followed fewer than 100 people and many were short-term or had high drop-out rates. As well, some trials didn't report suicides or attempts if there were fewer than a certain percentage.
That points to the problem of under-reporting in clinical trials, said Dr. Dean Fergusson, who headed up the Ottawa study.
"It leaves all of us in the dark. When you have serious adverse effects, they need to be reported. We would have known about this sooner if there was more rigorous reporting," he said.
But the head of the University of Ottawa's psychiatry department told the Globe and Mail that he is deeply concerned about the way the findings were presented.
"I don't agree with the press release in the way it was worded. Because I think it's extremely alarmist and it could do harm," said Dr. Jacques Bradwejn, who is also psychiatrist-in-chief at the Royal Ottawa and Ottawa hospitals.
Bradwejn worries the public will miss the important caveat that two times is a very small number. "It might overamplify the danger and the frequency of the danger," he told the Globe.
In fact, the Ottawa researchers insist SSRIs are still safe for the majority of patients.
Both Health Canada and the U.S. Food and Drug Administration have warned of an increased risk of rare but serious side-effects such as suicidal thoughts and behaviour in children and teens who take certain antidepressants. And regulators have boosted warnings on packaging for SSRIs.
Source: www.cbc.ca/story/scienc...de050218.html
The findings, published in the most recent issue of the British Medical Journal, have significant implications because of the widespread use selective serotonin reuptake inhibitors (SSRIs).
Scientists at the Ottawa Health Research Institute analyzed more than 700 clinical trials involving almost 90,000 patients taking SSRIs, which include drugs sold under the name brands Prozac, Cipramil and Zoloft.
The Ottawa study compared the reported number of suicide attempts by patients on the drugs to the number of attempts by patients taking a placebo.
The risk of suicide is somewhat expected with depression, but the study found that the drugs contributed to an increased risk in patients suffering from other conditions. Doctors also prescribe SSRIs to treat anxiety, post-traumatic stress disorder and social phobia.
"The very interesting thing is it's occurring in non-depressed individuals," said Dr. Paul Hebert, co-author of the study. "We're seeing it in some diseases where suicide is unexpected, for example in panic disorder."
The study's authors say the risk could be higher than their results show because the published clinical trials they examined have limitations.
Most of the trials followed fewer than 100 people and many were short-term or had high drop-out rates. As well, some trials didn't report suicides or attempts if there were fewer than a certain percentage.
That points to the problem of under-reporting in clinical trials, said Dr. Dean Fergusson, who headed up the Ottawa study.
"It leaves all of us in the dark. When you have serious adverse effects, they need to be reported. We would have known about this sooner if there was more rigorous reporting," he said.
But the head of the University of Ottawa's psychiatry department told the Globe and Mail that he is deeply concerned about the way the findings were presented.
"I don't agree with the press release in the way it was worded. Because I think it's extremely alarmist and it could do harm," said Dr. Jacques Bradwejn, who is also psychiatrist-in-chief at the Royal Ottawa and Ottawa hospitals.
Bradwejn worries the public will miss the important caveat that two times is a very small number. "It might overamplify the danger and the frequency of the danger," he told the Globe.
In fact, the Ottawa researchers insist SSRIs are still safe for the majority of patients.
Both Health Canada and the U.S. Food and Drug Administration have warned of an increased risk of rare but serious side-effects such as suicidal thoughts and behaviour in children and teens who take certain antidepressants. And regulators have boosted warnings on packaging for SSRIs.
Source: www.cbc.ca/story/scienc...de050218.html
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Re: Antidepressants increase risk of suicidal behaviour: study
Mon, February 21, 2005 - 11:09 AMI can't believe they're saying it leaves them in the dark.
It's widely known in the psychiatric community that suicide attempts are most common when the patient is only moderately depressed. People who are severely depressed lack the motivation to make any changes in their life and have a sense that there is little point to trying to control anything. Depression is ultimately a condition of perceived powerlessness to acheive positive affect, and suicide is ultimately just a way to take control over overwhelming negative affect. Having been suicidal myself (on SSRI's), I would say that people are probably seeing suicide as a potential cure for depression, and I can still agree with them; unless you've been there, you just don't know how that is.
OTOH, the migraine attacks I got from SSRI use would have been enough reason to jump under a train if I hadn't been depressed to begin with.
IMHO, if someone has an etiology similar to mine (PTSD), and they don't smoke cigarettes, I would quite strongly suggest that they start smoking rather than going on SSRI's. It worked for me!
