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Do Anti Depressants Cause Suicide? NO

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  • Do Anti Depressants Cause Suicide? NO

    Steve... always seem to have your fingers on the pulse of new science so I just assumed you would have the info at your finger tips is the info I have.....

    A few years ago there were warnings put out as per below:

    In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of PROZAC or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are starting therapy should be observed closely. Families and caregivers should discuss with the doctor any observations of worsening depression symptoms, suicidal thinking and behavior, or unusal changes in behavior. PROZAC is approved for use in pediatric patients (children and adolescents) with MDD or obsessive compulsive disorder (OCD).

    I was told by my son's doctor last Thursday (he is considering Prozac for my son) that there is a very new study that has not yet been released that basically states that although the suicidal thoughts may go up actual suicide completions went down. After the warning went out and many physicians took their patients off Prozac the suicide rates actually went up by I think 30% (I could be wrong on the number). I was further told that the only reason the suicidal thoughts go up is that the patient actually feels better and can actually think more about everything in general.

    I was just wondering if I could get my hands on this report before making any med decisions.
    Last edited by Steve; May 15, 2007, 06:56 PM. Reason: edits for clarification post merger

  • #2
    Do Anti Depressants Cause Suicide? NO

    Do Antidepressants Cause Suicide?
    by Chris Ballas, M.D.
    Monday, May 14, 2007

    First, and most importantly, the answer is no. No single thing can cause a complex behavior such as suicide (or violence), and to say that a drug, or event, or illness made someone do something is simplistic and, well, wrong.

    A more refined question would be whether antidepressants (or anything else) can contribute to the suicide process, move someone further along. Cocaine doesn't cause violence, but if you see a violent guy on cocaine, it's best to get out of the way.

    The FDA, in 2002 and 2004, issued warnings about suicidal ideations in children who take antidepressants. Here are a couple of points for us to consider.
    1. These were kids
    2. The point of discussion is suicidal ideation, not suicide (death) per se.

    The FDA reviewed nine, then later 24 pediatric studies and found that the risk of ideation "doubled" from two to four percent.

    The authors of a recent review of 29 studies found a similar small increase in risk. Importantly, however, no actual suicides occurred. They also analyzed whether or not the antidepressants were actually helpful to people, and weighted that finding against the risk of suicide. Their results determined the risk/reward ratio to be about 11:1, meaning that patients have 11 times better chance of being helped than hurt by antidepressants.

    I should point out that, in my opinion, while there is absolutely no compelling evidence that these drugs promote suicidality, there is also a lack of compelling evidence indicating that they reduce suicidality. Nor would I expect there to be. Again, these drugs may change how someone feels, but there are a million steps between a feeling and an action. Which has the greater impact on suicidality: medications or the availability of a gun?

    Asking the question simply, "do antidepressants cause suicide?" misses the meat of the argument. Cause? In whom? When, and under what circumstances? The real question is whether someone who is depressed is more likely to commit suicide off of the medicines than on them.

    So while we ponder that question, let me offer a sobering statistic. Only 30% of the people who committed suicide had seen a psychiatrist in the past year. That means 70% hadn't.

    Source: JAMA. 2007;297:1683-1696.
    TouretteLinks Forum


    • #3
      Re: Do Anti Depressants Cause Suicide? NO

      thanks Steve