Study questions SSRI link to suicide

The close monitoring of patients on antidepressants, especially adolescents, remains essential, researchers warn.

By Susan J. Landers — Posted Jan. 30, 2006

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Washington -- Antidepressants, particularly selective serotonin reuptake inhibitors, appear to lower the risk of suicide among adults and adolescents being treated for depression, according to a study in the January American Journal of Psychiatry.

The finding addresses concerns raised two years ago that the antidepressants Paxil (paroxetine hydrochloride) and Zoloft (sertraline hydrochloride), as well as others in their class, were responsible for increased risk of suicide attempts, especially among adolescents. The concerns resulted in black-box warnings for the SSRIs as well as a decrease in use.

The study, "Suicide risk during antidepressant treatment," examined 65,103 patients in a large health plan who filled prescriptions for antidepressants between 1992 and 2003.

The findings indicate that there was a decrease in suicide rates, not an increase, during the months following treatment with a range of antidepressant drugs, said Robert Freedman, MD, editor-in-chief of the psychiatric journal.

Nonetheless, the FDA's cautions calling for close monitoring of patients on the drugs should still be taken seriously, he said. "There are some people who become impulsive on these drugs. And that impulse can include suicide."

The study found that there were 314 suicide attempts per 100,000 children and adolescents and 78 attempts per 100,000 adults during the first six months of treatment with antidepressants. But the rate of attempted suicides was highest in the month before treatment began and declined by about 60% afterward, the researchers said. In addition, the risk of suicide was greater for treatment with older antidepressants, such as the tricyclic drugs, when compared with the newer SSRIs.

The findings are consistent with previous reports, said David Fassler, MD, clinical professor of psychiatry at the University of Vermont College of Medicine. "There is no evidence to suggest that SSRI antidepressants increase the risk of suicide. On the contrary, we know that access to comprehensive and appropriate treatment reduces the risk of suicide in patients with depression."

Back to top

External links

"Suicide risk during antidepressant treatment," abstract, American Journal of Psychiatry, January (link)

"Safety and efficacy of selective serotonin reuptake inhibitors in children and adolescents," AMA Council on Scientific Affairs report, 2005 (link)

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn