Meds and Suicide

Over the past several years, there have been lots of stories, and some weak studies, claiming to show a link between anti-depressants and suicide. Specifically, the family of anti-depressants called "SSRI's" has been implicated in increasing suicides.

I've always thought these claims were nonsense. But the media, defense attorney's, and some patients have continued the drum beat. Now there's this study from Health Central:

SUNDAY, Jan. 1 (HealthDay News) -- Contrary to what has been feared, the antidepressants known as serotonin reuptake inhibitors (SSRIs) are initially effective in as many as one-third of depressed patients and don't appear to increase the risk of suicide, two new studies claim.

...

The suicide findings seem to challenge a 2004 advisory by the U.S. Food and Drug Administration that warned that suicidal behavior may increase after treatment with SSRIs. However, the study did find that suicide attempts were higher among teens than adults, a finding borne out by other research.

...

"This study, when it is all finally published, will give us a very good idea of how to treat treatment-resistant depression, and what the next step is after the SSRI fails," said Dr. David L. Dunner, director of the University of Washington's Center for Anxiety and Depression.

In the second study, researchers found the risk of suicide attempts and of successful suicides actually dropped in the weeks following the start of SSRI therapy.

"The risk of a serious suicide attempt in people who start taking antidepressant medication is, fortunately, quite low -- less than one in 1,000," said lead author Dr. Greg Simon, a researcher at the Group Health Cooperative, in Seattle. "The risk actually goes down after people start antidepressant medication."

Every ... single ... brand ... new ... therapist-in-training learns a very important lesson, right out of the chute. When a patient is severely depressed and suicidal, the most dangerous time for suicide is right when the individual begins to recover. The reason for this is quite simple. At the depths of a suicidal depression, individuals simply do not have the energy needed to carry out the suicide. However, once that individual's energy begins to improve (but not necessarily their mood), suicide then becomes a larger possibility. And a larger danger. Well guess what happens in the most initial phase of medication treatment?

I hope this puts some of the hysteria to bed. But somehow, I doubt it.