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Antidepressant Suicide Risk Highest for Those Under 25

Aug 12, 2009 | Parker Waichman LLP

The risk of suicide from antidepressants is highly-age dependent with people under 25 facing the highest risk, according to a new Food & Drug Administration (FDA) analysis.  According to a Reuters report, researchers said the findings support the agency's strong warnings on antidepressant drug labeling for people under 25.

As we've reported previously, in 2005 the FDA mandated that all selective serotonin reuptake inhibitors (SSRIs), such as Zoloft, Celexa and Prozac bear Black Box warnings - its strongest safety notice - regarding the association between the drugs and suicidal events in children and adolescents.   A year later the warning was expanded to include young adults.

This new FDA analysis, which was published on the British Medical Journal website, involved a review of 372 trials involving nearly 100,000 people who took antidepressants.  According to a U.S. News and World Report article, it found that the drugs increase the risk for suicide in people younger than 25, have no effect in those 25 to 64 and reduce risk in those 65 and older.  

In the youngest group, the risk of suicidal thoughts and behaviors among those on antidepressants were up to 2.3 times more common than those who were given a placebo. Of the almost 99,231 patients included in the review, eight committed suicide, 134 attempted suicide and 10 made preparations without actually trying to kill themselves.  Another 378 patients said that they had thought about committing suicide but had not acted.

In an editorial that accompanied the study, Prof John Geddes and colleagues from the University of Oxford wrote that uncertainty remained over the role of the drugs in promoting suicidal thoughts.   However, the authors wrote that it is "apparent that antidepressants vary in both their efficacy and adverse effects."

According Reuters, the commentary also noted that the analysis found the risk of suicidal events varied between different SSRIs.  For instance, the odds of suicidal behavior by people taking Zoloft were around half compared to those who took a placebo.   At the same time, Lexapro seemed to increase the risk of suicidal events.

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