I just heard on the radio that antidepressants will now be dispensed with a label warning of the increased risk of suicide by taking them.
What exactly is causing these medications to cause suicidal tendencies in some of the people to whom they are prescribed?
I find it odd that a medication that is designed to balance the neurotransmitters in those suffering from depression would cause these people such despair that they would want to kill themselves.
I am concerned, as I have been on antidepressants for 4 years. So either I go yodeling off to nuthouse or I’m swinging by my neck from a rafter?
Quite grim. Quite.
I believe the recent events that spurred this was related to teenagers and increased suicide risk while on antidepressants.
It has been (to the best of my recollection) understood for some time that certain people who were very “numb” or amotivated previously might occasionally be at risk for committing suicide simply because the antidepressants helped with their energy levels and to remove that “numb” emotional state. I do not know if this is the case with these most recent warnings, however.
I would suspect that this wouldn’t be an issue with a drug that you’ve been on for some time, but if you have further questions, speaking to the prescribing doctor would be your best move. (IANAD/nurse/psychiatrist, etc., etc.)
As I understand it, there’s no evidence that antidepressants are causing an increased risk of suicide, merely that there’s a correlation between use of antidepressants and increased risk of suicide. Which, if you think about it, is one of those “Well, duh!” sort of things: people who’re depressed enough to need antidepressants are more likely to be suicidal – who’d have guessed that? :rolleyes: .
Note that there’s also no evidence that antidepressant’s aren’t responsible for the increase in suicidal tendencies either, of course. More research is needed, as they say. A warning like this is sort of a double-edged sword: on the one hand, you want people who’re taking antidepressants to be aware that there’s a possibility that the medication might lead to an increased risk of suicide so that they can recognize that if it occurs and deal with it with their mental health provider, but on the other hand the warning may scare some people aware from using antidepressants, which might lead them to become more depressed, which might lead to . . . an increased risk of suicide. I’m afraid that the warnings as they’re worded may lead to more of the latter than the former.
IIRC this is an incorrect statement. The studies this is based on took two groups of troubled teenagers. Both were identified as depressed and given counceling. One group was given anti-depressants and the other was given the placebo. The anti-depressant group had a higher suicide rate.
This is mostly anecdotal, but I had hit a pretty low point in my life, and I basically decided to be apathetic to the world. As I started recovering from this deep blue funk, I had to go through a period of time where I still felt pretty freaking lousy, but obviously making progress to a better and brighter future, or something. A person with clinical depression, especially an adolescent lacking life experience, might misinterpret this transition phase as something horrendously awful and to be avoided at all costs.
(The analogy I was given was that a burn victim will start to feel intense pain as their nerves regenerate.)
I suppose we should clarify that most of this type of concern has been about selective serotonin reuptake inhibitors (SSRIs) – the class of antidepressants that includes Prozac, Paxil, Zoloft, and others. There are other antidepressants that do not fall into this class, and that AFAIK are not involved in these warnings/concerns.
There has also been concern about the use of SSRIs in children and adolescents in general. What clinical data there is, as I understand it, suggests that SSRIs at best are less effective for treating depression in children and adolescents than in adults, and may be deleterious in some cases. On the other hand, the clinical data suggests that SSRIs are both safe and effective for treating obsessive-compulsive disorders in children and adolescents.
More info:
SSRIs in children and adolescents: Where do we stand? (Current Psychiatry)
Questions and Answers about the NIMH Treatment for Adolescents with Depression Study (TADS)
That’s exactly the right answer.
I was told that the risk is that antidepressants can motivate someone who was contemplating suicide to actually carry it out. This would probably be most likely to happen in the stage where the antidepressant has a subtle effect on the patient’s emotions but has not yet reached its full effectiveness. (With many antidepressants this can take 3-6 weeks.) The drug hasn’t yet alleviated the patient’s depression, but they may be more motivated to attempt suicide. Apparently this occurs more in adolescents, perhaps due to motivational or other psychological factors, and perhaps because they have different neurochemistries than adults.
I don’t know how related this is, but when I suffered from depression alot worse than my current depression I decided to try 5HTP, which is a percursor for serotonin and an anti-depressant. So instead of taking a drug that inhibited the reuptake pumps for serotonin like an SSRI I took an herbal medicine that created more serotonin in my brain.
For the first week I noticed my depression got markedly worse for some reason and I still don’t know why. If people on SSRIs get the same effect of their depression getting alot worse at first that would explain why suicide rates went up.
In my Abnormal Psychology class, we were told that suicidal tendencies are highest when the person is going into or coming out of depression, as opposed to being at the lowest point of depression. The correlation between antidepressants and suicide seems to make sense to me when looked at this way, seeing as their function is to help bring people out of depression.
Apparently this will be a blanket warning that will include older TCAs and MAOIs as well as the newer SNRIs (e.g. Effexor) and “atypicals” (e.g. Wellbutrin).
From this article: