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Antidepressants May Not Decrease Suicide Risk

Oct 28, 2003 |

Approximately 18.8 million American adults age 18 and older have a depressive disorder, according to Congressional Black Caucus Foundation.

Although studies indicate that treatment of depression has led to a slight decrease in the suicide rate, other research shows that drugs can aggravate suicide attempts.

The Food and Drug Administration issued a public health advisory Monday to alert doctors to reports that children and teenagers with major depression thought about or attempted suicide during several clinical trials of antidepressants.

The controversy surrounding antidepressants and increased suicide risk first arose this past June when the FDA issued a warning to distributors of the popular antidepressant Paxil. In a statement, the agency revealed that it was reviewing reports showing a possible link between Paxil and increased risk of suicidal thinking and suicide attempts in children.

According to an FDA statement yesterday, the agency is "aware of press and medical journal reports of suicide attempts and completed suicides in pediatric patients receiving antidepressants, and many such reports have also been submitted to FDA as spontaneous reports."

Dr. Susan Brown, a psychologist at Madison's Mental Health Resources, said she disagrees with these recent reports.

"I think suicide rates are definitely going down," she said. "By and large it is not true that people on antidepressants have higher suicide rates, but it is extremely important that medication management is monitored by a professional and paired with intense psychotherapy."

Brown's comments are consistent with a recent report in the Archives of General Psychiatry, based on a study of antidepressant use and suicide rates among teens in 588 U.S. postal codes during the '90s.

The researchers analyzed data from several sources, including a major pharmacy benefit program, national suicide mortality files and the U.S. census, to find that overall, a 1 percent rise in antidepressant use by teens was accompanied by a drop of 0.23 suicides per 100,000 adolescents per year.

Dr. Jeffrey Anders, a UW clinical assistant professor of psychiatry, also said he believes antidepressants do more good than bad.

"The benefits of antidepressants for significant depression symptoms greatly outweigh the risks," he said. He added that some of the side effects include jitteriness, dizziness and irritation. He said these effects can alarm some patients with major depression, but as long as they are monitored, the medications can truly help.

Brown said she agrees with this distinction.

"We have to monitor antidepressant use properly. There might be changes in mood that you have to watch, but as long as patients are attended by professionals, these side effects can be controlled," she said.

The FDA has scheduled a meeting for Feb. 2, 2004, with the Psychopharmacologic Drugs Advisory committee and the Pediatric Subcommittee of the Anti-Infective Drugs Advisory Committee to further discuss these concerns.

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