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 […]
Physician perception regarding side-effect profile at the onset of antidepressant treatment: A survey of Israeli psychiatrists and primary care physicians.
One of the major factors affecting treatment compliance and outcome in patients is the wide range of side effects (SEs) associated with antidepressants. In the present study, we aimed to assess the extent to which Israeli primary care (PC) physicians and psychiatrists discuss the SEs of selective serotonin reuptake inhibitors (SSRIs) with patients prior to […]
Early onset of action and sleep-improving effect are crucial in decreasing suicide risk: the role of quetiapine XR in the treatment of unipolar and bipolar depression
Although the possibilities of antidepressive pharmacotherapy are continuously improving, the rate of nonresponders or partial responders is still relatively high. Suicidal behavior, the most tragic consequence of untreated or unsuccessfully treated depression, commonly observed in the first few weeks of antidepressive treatment before the onset of therapeutic action, is strongly related to certain symptoms of […]
Suicidality: Risk Factors and the Effects of Antidepressants. The Example of Parallel Reduction of Suicidality and Other Depressive Symptoms During Treatment with the SNRI, Milnacipran
A recent study has determined the effects of 6 weeks of antidepressant treatment with the serotonin & norepinephrin reuptake inhibitor, milnacipran, on suicidality in a cohort of 30 Russian patients with mild to modertate depression. At baseline, mild suicidal thoughts were present in 46.7% of patients. Suicidal thoughts decreased progressively throughout the study in parallel […]
Antidepressants and Suicide Risk: how did Specific Information in FDA Safety Warnings Affect Treatment Patterns?
This study found the timing of the American Food & Drug Administration recommendations was associated with trends in the use of paroxetine & fluoxetine by children with major depressive disorder who were initiating antidepressant treatment. However, no evidence of increases in outpatient visits (indicative of monitoring) among depressed children initiating antidepressant use was found. Release […]
Suicide Risk in Schizophrenia – a Follow-Up Study After 20 Years. Part 2: Symptomatology and Pharmacotherapy
Suicide risk was reevaluated in a group of patients with schizophrenia who were considered to be at high risk 20 years previously. Symptomatology & pharmacotherapy were investigated. Subjects were interviewed & a questionnaire evaluating suicide risk was completed along with other scales. Psychological autopsies were performed for 3 subjects who had died by suicide. 14 […]
This article reviews research on the safety of paroxetine, an antidepressant. Studies from Norway, the United States, and the United Kingdom are discussed. The study from Norway found that patients taking paroxetine were more likely to attempt suicide than those taking a placebo.
Selective Serotonin Reuptake Inhibitors for Children and Adolescents With Major Depression: Current Controversies and Recommendations
Published safety & efficacy trials of selective serotonin reuptake inhibitors for the treatment of youth with depression were critically reviewed & augmented by information from regulatory hearings in 2003-2004 & selected open-label reports. Based on this review, recommendations for medication treatment & monitoring are provided. Emerging data from several clinical trials show these drugs provide […]
Predictors of Spontaneous and Systematically Assessed Suicidal Adverse Events in the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) Study
334 depressed adolescents who had not responded to a previous trial with a selective serotonin reuptake inhibitor antidepressant were randomized to a switch to another selective serotonin reuptake inhibitor or venlafaxine, with or without cognitive behaviour therapy. Self-harm events were assessed by spontaneous report from the first 181 participants & by systematic weekly assessment for […]
This study compared the change in clinical parameters & resource utilization at 1 month in a group of 496 Canadian patients requiring treatment intervention for exacerbation of mania. The clinical response at 1 year was also evaluated. Patients were divided into the Olanzapine cohort, 287 patients, & the Other cohort, 209 patients who had a […]
This study determined the effects of sertraline on suicidal thinking & behavior in patients with late-life major depression. This was a secondary analysis of an 8-week, placebo-controlled, double-blind randomzied trial. A total of 747 patients received at least one dose of medication & 728 had at least one posttreatment assessment. There were no suicides or […]
The objective of this study was to determine if antiepileptic drugs increase the risk of suicide attempt in patients with bipolar disorder. The study included a cohort of 47,918 patients with bipolar disorder with a minimum 1-year window of information before & after the index date of their illness. Overall, there was no significant difference […]
Is There Evidence for Negative Effects of Antidepressants on Suicidality in Depressive Patients? A Systematic Review
This paper gives a systematic & comprehensive review of the empirical data which might indicate that antidepressants have negative effects on suicidality. First, principal methodological issues related to this research question are discussed. Thereafter, the results of controlled trials & epidemiological & cohort studies are presented. Altogether, there seems to be only a small amount […]
Do SSRIs or Antidepressants in General Increase Suicidality? WPA Section on Pharmacopsychiatry: Consensus Statement
The authors undertook a comprehensive review of publications related to the topics antidepressants, suicide, suicidality, suicidal behaviour, & aggression. Based on the review, it was concluded that antidepressants, including selective serotonin reuptake inhibitors, carry a small risk of inducing suicidal thoughts & suicide attempts, in age groups below 25 years, the risk reducing further at […]
File copy includes a correction published in the June 9, 2010 issue of this journal.
Does the FDA Proposed List of Possible Correlates of Suicidality Associated With Antidepressants Apply to an Adult Private Practice Population?
This report examines the relevance of the American Food & Drug Administration’s list of possible correlates of suicidality & antidepressant drugs for adults. 650 consecutive outpatients presenting with a major depressive episode to a private practice were interviewed. Suicide ideation was present in 49.3% of the sample & was significantly greater in bipolar II than […]
Ecological, cohort, & case-control studies & data from brief, randomized controlled trials in patients with acute affective disorders have found increases, particularly in young patients & particularly for the risk of suicide attempts, as well as increases in suicide ideation in young patients. Whether antidepressants are associated with specific aspects of suicidality in younger patients […]
This article examines the relationship between depression & suicide. New studies have shown a link between suicidal behaviours & children & adolescents who have been prescribed selective serotonin reuptake inhibitors. These studies & the American Food & Drug Administration’s advisories are briefly reviewed. It is concluded more research is needed to establish direct clinical correlations. […]
Factors Associated With Anxiety, Depression and Suicide Ideation in Female Outpatients with SLE in Japan
84 female Japanese outpatients with systemic lupus erythematosus were studied. Trait anxiety, state anxiety, depression, & suicide ideation were evaluated using psychological tests & the relationships between the respective psychological features & background factors were statistically evaluated using stepwise multiple logistic regression analyses. “Human relations among family members” & “high daily steroid dosage” were found […]
This article reviews current understanding of risks of adverse behavioural responses to antidepressant treatment. A series of 10 illustrative cases is reported after briefly reviewing the relevant research literature. In each case, rapid improvement followed recognition of the problem, stopping or curtailing antidepressant treatment or with the addition or substitution of another drug. The authors […]
In this editorial, the author briefly reviews articles published in the November & December 2007 issues of this journal on various aspects of suicide & suicidal behaviours. (1 ref.)
In this commentary, the authors address the ongoing discussion of potential increases in suicide risk among patients being treated with antidepressant drugs. A comprehensive meta-analysis failed to show either increased or decreased risk with antidepressants of all types, nor significant differences between serotonin reuptake-inhibitors & tricylics. The authors propose prudent clinical practice calls for particularly […]