Antidepressant treatment trajectories and suicide attempt among Australians aged 45 years and older: A population study using individual prescription data

Introduction Meta-analyses show antidepressant initiation has increased risk of suicidal behavior <25 years, no difference 25–64 years and reduced risk 65+ years. Estimating risks from RCTs has limitations and real-world population estimates are uncommon. Methods A self-controlled case series reporting incidence rate ratio (IRR) between exposed and control periods for antidepressants associated with suicide attempt, in Australian […]

Suicidal behavior: Advances in clinical and neurobiological research and improvement of prevention strategies

Suicide is the 14th leading cause of death worldwide. It is responsible for 1%-5% of all mortality. This article highlights the latest developments in universal, selective, and indicated prevention strategies. Concerning universal suicide prevention, current research has shown that strategies such as restricting access to lethal means (e.g., control of analgesics and hot-spots for suicide by […]

Incremental burden of relapse in patients with major depressive disorder: A real-world, retrospective cohort study using claims data

Background Relapse is common in major depressive disorder (MDD). In this study, we evaluated the incremental health care burden of relapse in patients with MDD. Methods This real-world retrospective cohort study used administrative medical and pharmacy claims data to identify commercially insured adult patients in the United States diagnosed with MDD who initiated a new […]

Role of ketamine in the treatment of psychiatric disorders

Purpose of review This is a comprehensive review of the literature regarding the use of ketamine as a treatment for treatment-resistant depression (TRD). It covers the epidemiology, risk factors, pathophysiology, and current treatment modalities regarding Major Depressive Disorder (MDD) and TRD. It provides background on the mechanism of action of ketamine, its history, current approved […]

Electrophysiological correlates and predictors of the antidepressant response to repeated ketamine infusions in treatment-resistant depression

Background: Sub-anesthetic ketamine doses rapidly reduce depressive symptoms, although additional investigations of the underlying neural mechanisms and the prediction of response outcomes are needed.  Electroencephalographic (EEG)-derived measures have shown promise in predicting antidepressant response to a variety of treatments, and are sensitive to ketamine administration. This study examined their utility in characterizing changes in depressive […]

Evaluation of factors related to overdose in patients with impaired consciousness who are transported by emergency medical services: An age-specific research

Background: Drug overdose accounts for most of the admissions to the emergency department. Prescription drugs, most of which are psychotropic medications, are often misused for drug overdose. The purpose of this study was to investigate the association between overdose in patients transported with disorders of consciousness and psychotropic medications administered prior to transport, so as to […]

Long-run trends in antidepressant use among youths after the FDA black box warning

Objective: In October 2004, the Food and Drug Administration directed pharmaceutical companies to issue a black box warning about the potential link between the use of antidepressants and suicidal ideation among children. This study analyzed long-run trends in antidepressant use among children before and after the black box warning for those with and without severe psychological […]

The effect of income level on all-cause mortality and suicide among patients using antidepressants: A population-based cohort study

Background: To investigate whether household income levels are associated with all-cause mortality and suicide in patients using antidepressant agents. Methods: We analyzed data from 75,782 patients using antidepressants, acquired from the Korean National Health Insurance claims database (2002-2013). Each patient was monitored until December 2013 or until death, whichever occurred sooner. Cox proportional hazard models were used […]

Suicide risk with selective serotonin reuptake inhibitors and other new-generation antidepressants in adults: A systematic review and meta-analysis of observational studies

Background: There is ongoing controversy whether antidepressant use alters suicide risk in adults with depression and other treatment indications. Methods: Systematic review of observational studies, searching MEDLINE, PsycINFO, Web of Science, PsycARTICLES and SCOPUS for case-control and cohort studies. We included studies on depression and various indications unspecified (including off-label use) reporting risk of suicide and/or suicide […]

Increases in suicide deaths among adolescents and young adults following US Food and Drug Administration antidepressant boxed warnings and declines in depression care

Objective Studies show decreased depression diagnosis, psychotherapy, and medications and increased suicide attempts following US Food and Drug Administration antidepressant warnings regarding suicidality risk among youth. Effects on care spilled over to older adults. This study investigated whether suicide deaths increased following the warnings and declines in depression care. Methods We conducted an interrupted time […]

Duty to warn: Antidepressant black box suicidality warning is empirically justified

The United States Food and Drug Administration issued a Black Box warning in October 2004 after placebo-controlled trials of antidepressant medications found an increased risk of suicidal thoughts and behaviors among children and adolescents taking antidepressant medications relative to placebo. Subsequently, some researchers have concluded that the Black Box warning caused severe unintended consequences; specifically, […]

The FDA “black box” warning on antidepressant suicide risk in young adults: More harm than benefits?

The decision made in the year 2004 by the U.S. Food and Drug Administration (FDA) to require a boxed warning on antidepressants regarding the risk of suicidality in young adults still represents a matter of controversy. The FDA warning was grounded on industry-sponsored trials carried one decade ago or earlier. However, within the past decade, […]

Antidepressants and suicidality: History, the black-box warning, consequences, and current evidence

The first published literature on the topic of antidepressants and suicidality dates back to the mid-1950s. Today, 10 years after the black-box warning was issued, this controversial topic is still debated. This article will review the data behind the black-box warning and its revision; address the subsequent impact the warning had on depression diagnoses, prescribing […]

Sociodemographic and gender determinants of late-life suicide in users and non-users of antidepressants

Background The treatment of depression is a main strategy for suicide prevention in older adults. Our aim was to examine factors related to suicide in older adults (75+) with and without antidepressant (AD) therapy. Methods A national population-based register study, including all Swedish residents aged ≥75 years between 2006 and 2014 (N = 1 413 806). A nested case–control design […]

Effects of bupropion (wellbutrin) on suicidal behavior, risk taking behavior, and mood

This study analyzed the effects that the well known antidepressant Wellbutrin (Bupropion) has on risk taking behavior, suicidal behavior, social behavior, and motivation. Despite Bupropion’s ability to improve motivation it has been associated with numerous suicides. There have been reports that state that Bupropion is the worst antidepressant for treating suicidal behaviors and may even […]

Antidepressant dose, age, and the risk of deliberate self-harm

OBJECTIVE: To assess the risk of deliberate self-harm by antidepressant dose, by age group. DESIGN, SETTING, AND PARTICIPANTS: This was a propensity score-matched cohort study using population-based health care utilization data from 162,625 US residents with depression ages 10 to 64 years who initiated antidepressant therapy with selective serotonin reuptake inhibitors at modal or at […]

Problematic advice from suicide prevention experts

Based on a 10-year systematic review of suicide prevention strategies, “29 suicide prevention experts from 17 European countries” recommend 4 allegedly evidence-based strategies to be included in national suicide prevention programs. One of the recommended strategies is pharmacological treatment of depression. This recommendation is problematic for several reasons. First, it is based on a biased […]

Newer-generation antidepressants and suicide risk in randomized controlled trials: A re-analysis of the FDA database

The aim of this paper was to examine whether the use of newer-generation antidepressants, relative to placebo, bear an increased risk of (attempted) suicide when the analysis is based on the number of patients instead of patient exposure years (PEY.)

Concurrent use of benzodiazepines, antidepressants, and opioid analgesics with zolpidem and risk for suicide: A case-control and case-crossover study.

Purpose To evaluate whether the concurrent use of benzodiazepines, antidepressants, and opioid analgesics with zolpidem increases the risk of suicide or triggers suicide compared with the use of zolpidem alone. Methods We conducted a case–control and case–crossover study using the Korean National Health Insurance ServiceNational Sample Cohort database. Cases were older than 20 years with a […]

Antidepressant use among persons aged 12 and over: United States, 2011-2014.

Antidepressants are one of the three most commonly used therapeutic drug classes in the United States (1). While the majority of antidepressants are taken to treat depression, antidepressants can also be taken to treat other conditions, like anxiety disorders. This Data Brief provides the most recent estimates of antidepressant use in the U.S. noninstitutionalized population, […]

Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: Cohort study using a primary care database.

Objective To assess the associations between different antidepressant treatments and the rates of suicide and attempted suicide or self harm in people with depression. Design Cohort study. Setting Patients registered with UK general practices contributing data to the QResearch database. Participants 238 963 patients aged 20 to 64 years with a first diagnosis of depression between 1 January 2000 and […]

Precursors to suicidality and violence on antidepressants: Systematic review of trials in adult healthy volunteers.

OBJECTIVE: To quantify the risk of suicidality and violence when selective serotonin and serotonin-norepinephrine reuptake inhibitors are given to adult healthy volunteers with no signs of a mental disorder. DESIGN: Systematic review and meta-analysis. MAIN OUTCOME MEASURE: Harms related to suicidality, hostility, activation events, psychotic events and mood disturbances. SETTING: Published trials identified by searching […]

Antidepressants and suicide: Risk-benefit conundrums.

There has been a long-standing controversy about the possibility that selective serotonin reuptake inhibitor (SSRI) antidepressants might induce suicidality in some patients. To shed light on this issue, this paper reviews available randomized controlled trials (RCTs), meta-analyses of clinical trials and epidemiological studies that have been undertaken to investigate the issue further. The original clinical […]