Antidepressant drug should have suicide warning for adults as well as children

According to a Norwegian study, adults taking the antidepressant drug paroxetine are at a higher risk of attempting to commit suicide than those not taking medication.

In this new analysis, of previous clinical data on paroxetine use, the antidepressant is added to the list of Selective Serotonin Reuptake Inhibitors (SSRIs) that have been shown to increase suicidal tendencies in adult patients with depression.

In their study Ivar Aursnes and colleagues from the University of Oslo, Norway, re-examined data from 16 selected paroxetine trials, in which patients diagnosed with depression had been randomly given either paroxetine or a placebo drug.

Neither the participants nor the researchers conducting the initial studies knew what the participants had been given.

Aursnes and his team did a statistical analysis of the results of these studies, in order to evaluate the incidence of suicide attempts in both groups.

Their work took into account the amount of time the participants had been exposed to paroxetine, and their results discovered that there were seven suicide attempts in the group on paroxetine, but only one among the patients on the placebo.

Although it is recognised that Paroxetine can increase suicidal attempt rates in children and teenagers, previous studies have failed to reach a conclusion regarding the effects of the drug on suicide attempt rates in adult patients.

Way back in February this year, David Gunnell of Bristol University and colleagues, warned doctors about an increased risk of suicidal behaviour in patients treated with SSRIs.

Their conclusion was based on analyses of clinical data submitted by the pharmaceutical companies that produce SSRIs to the Medicine and Healthcare Products Regulatory Agency.

But in their study Gunnell's data on paroxetine was inadequate.

However Aursnes and team advise that the recommendation of restrictions in the use of paroxetine in children and adolescents, should include usage in adults.

They confirm that all SSRIs increase suicidal tendencies in depressed adults and say their work suggests the use of SSRIs are connected with "increased intensity per year of suicidal attempts".

Aursnes's study is published in BioMed Central | BMC Medicine.

Gunnell's study can be seen in the February 19th 2005 issue of the British Medical Journal (BMJ).