Antidepressants lower the risk of suicide attempt in adults with depression

Antidepressants lower the risk of suicide attempt in adults with depression, according to a study published in the July issue of the American Journal of Psychiatry.

"The risk of suicide attempt among depressed patients treated with SSRI drugs was about one-third that of patients who were not treated with an SSRI," said the lead author Robert Gibbons, director of the Center for Health Statistics and professor of biostatistics and psychiatry at the University of Illinois at Chicago. "We would not expect a lower risk in this patient population because patients treated with SSRIs are generally more severely depressed and would have a higher risk of suicide attempt."

The researchers analyzed medical data of 226,866 patients newly diagnosed with depression in 2003 or 2004 at the Veterans Administration healthcare system. They compared risk of suicide in four age groups (ages 18 to 25; 26 to 45; 46 to 65; and older than 65) before and after treatment with selective serotonin reuptake inhibitor medications, also known as SSRI drugs.

All age groups of depressed patients who received selective serotonin reuptake inhibitors -- the most commonly prescribed antidepressant medication -- showed a significantly lower risk of suicide attempt when compared to those who did not receive antidepressant treatment.

Among 82,828 patients, there were 183 suicide attempts before treatment with SSRI drugs and 102 suicide attempts after treatment with SSRI drugs (a rate that fell from 221 to 123 per 100,000 after treatment).

In 2004, the Food and Drug Administration issued a black box warning suggesting that SSRI drugs increase the risk of suicidal behavior in children and adolescents. An FDA advisory committee recently recommended extending this black box warning to young adults.

Gibbons cautions that extending this warning to young adults may further decrease antidepressant treatment of depression and contribute to higher rates of suicide.

In previous research, Gibbons reported an inverse relationship between antidepressant prescriptions and the rates of suicide in children and adolescents.

Co-authors of the study include Kwan Hur and Dulal Bhaumik, UIC Center for Health Statistics; C. Hendricks Brown, University of South Florida; Sue Marcus, Mount Sinai School of Medicine; and J. John Mann, Columbia University.

Funding for the study was provided by the National Institute of Mental Health.

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