SSRIs: Clarifying the Suicide Risk
Reported February 09, 2009
(Ivanhoe Newswire) — Much has been written about the link between drugs used to treat depression and the risk of suicide.
A study conducted by the Food and Drug Administration (FDA) in 2007 suggested a lower risk among the elderly, no increased risk among adults, and an increased risk among those age 25 and younger. Those findings led to black box warnings on the drugs alerting people to the possibility of an elevated risk in children and young people.
Now a new meta-analysis conducted by investigators from the World Health Organization and the University of Verona in Italy is adding even more fuel to the fire. Their review of eight large observational studies on selective serotonin reuptake inhibitors (SSRIs) and suicide suggests these medications actually reduce the risk in adults.
The researchers believe these results should reassure people that SSRIs are safe and effective for the treatment of depression in adults, although they emphasize children and younger people should still be closely monitored when on these medications to ensure they are not having suicidal thoughts.
Clarifying the role of SSRIs in suicide risk is important, because these drugs are a mainstay in the arsenal against depression, and concerns about their use may mean people are going without treatment.
In a commentary on the study, Dr. John Mann, from Columbia University, and Dr. Robert Gibbons, from the University of Illinois, note fewer prescriptions are being written for SSRIs and, even more troubling, fewer than expected diagnoses are being made for mood disorders in the wake of the FDA warning. They believe doctors may simply be avoiding labeling people with depression. The solution? They call for randomized controlled trials on the use of these drugs in younger people to more clearly define their effects.
SOURCE: CMAJ, published online February 2, 2009
