TITLE

Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies

AUTHOR(S)
Barbui, Corrado; Esposito, Eleonora; Cipriani, Andrea
PUB. DATE
February 2009
SOURCE
CMAJ: Canadian Medical Association Journal;2/3/2009, Vol. 180 Issue 3, p291
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: It is unclear whether the use of selective serotonin reuptake inhibitors (SSRIs) and other antidepressant drugs reduce the risk of suicide in people with depression. We explored the association between exposure to SSRIs and risk of suicide completion or attempt. Methods: We conducted a systematic review of observational studies that reported completed or attempted suicide in depressed individuals who were exposed to SSRIs compared with those who were not exposed to antidepressants. We assessed the overall risk of completed or attempted suicide. Results: Eight studies involving more than 200 000 patients with moderate or severe depression were included in the meta-analysis. Although exposure to SSRIs increased the risk of completed or attempted suicide among adolescents (odds ratio [OR] 1.92, 95% confidence interval [CI] 1.51-2.44), the risk was decreased among adults (OR 0.57, 95% CI 0.47-0.70). Among people aged 65 or more years, exposure to SSRIs had a protective effect (OR 0.46, 95% CI 0.27-0.79). Sensitivity analyses did not change these findings. In particular, for studies that used completed suicide as an outcome, exposure to SSRIs was associated with increased risk among adolescents (OR 5.81, 95% CI 1.57-21.51) and decreased risk among adults (OR 0.66, 95% CI 0.52-0.83) and older people (OR 0.53, 95% CI 0.26-1.06). Interpretation: Based on data from observational studies, use of SSRIs may be associated with a reduced risk of suicide in adults with depression. Among adolescents, use of SSRIs may increase suicidality.
ACCESSION #
36208343

 

Related Articles

  • Antidepressants and suicide: what is the balance of benefit and harm. Gunnell, David; Ashby, Deborah // BMJ: British Medical Journal (International Edition);7/3/2004, Vol. 329 Issue 7456, p34 

    Presents a clinical review to evaluate the risk of suicide in patients taking antidepressant agents. Concern that serotonin reuptake inhibitors may precipitate suicidal behavior; Report that the rates of prescribing antidepressant drugs have increased in Great Britain while rates of suicide...

  • Overprescribing antidepressants to children: pharmacoepidemiological study in primary care. Bennett, Kathleen; Teeling, Mary; Feely, John // BMJ: British Medical Journal (International Edition);12/17/2005, Vol. 331 Issue 7530, p1451 

    The article evaluates the level of use of antidepressants in adults and children in Ireland, the drug type and duration of use, and the changes in prescription rates over time. Antidepressants are widely used to treat depressed adults, but are not licensed for use in children because of...

  • New warnings on SSRIs 'unlikely.'  // Pulse;6/21/2004, Vol. 64 Issue 25, p7 

    Denies that the Committee on Safety of Medicines will conclude that selective serotonin reuptake inhibitors pose suicide risk in adults. Reluctance of general practitioners in Great Britain to prescribe antidepressants; Confusion over how to treat depression.

  • Prescribing in depression. Warren, Ed // Practice Nurse;12/9/2011, Vol. 41 Issue 20, p26 

    The article discusses depression and the treatment options available. It explains the medication for depression such as selective serotonin reuptake inhibitors (SSRI), Tricyclic antidepressants (TCA), and Monoamine oxidase inhibitors (MAOI). It also offers information on alternatives to drug...

  • Teen suicide rate rises as prescribing of SSRIs falls. Dyer, Owen // BMJ: British Medical Journal (International Edition);9/15/2007, Vol. 335 Issue 7619, p531 

    This article reports that "black box" warnings ordered in the U.S. on selective serotonin reuptake inhibitors (SSRIs) may have had the opposite effect from that intended. Research compared the number of prescriptions for the drug to reported suicides in the U.S and the Netherlands and found...

  • Is there evidence for negative effects of antidepressants on suicidality in depressive patients? Möller, Hans-Jürgen // European Archives of Psychiatry & Clinical Neuroscience;2006, Vol. 256 Issue 8, p476 

    The role of antidepressants in suicide prevention is a major public health question given the high prevalence of both depression and depression-related suicidality. Therefore all available means should be utilised to clarify the influence of antidepressants on suicidality, especially in view of...

  • Efficacy of antidepressants in adults. Moncrieff, Joanna; Kirsch, Irving // BMJ: British Medical Journal (International Edition);7/16/2005, Vol. 331 Issue 7509, p155 

    Offers a debate regarding the efficacy of antidepressants in adults. Report that the National Institute for Health and Clinical Excellence (NICE) recommended that antidepressants, such as selective serotonin reuptake inhibitors, should be first line treatment for moderate or severe depression;...

  • Suicide and Antidepressants: What Current Evidence Indicates. Nischal, Anil; Tripathi, Adarsh; Nischal, Anuradha; Trivedi, J. K. // Mens Sana Monographs;Jan-Dec2012, Vol. 10 Issue 1, p33 

    The documented efficacy and long-term benefit of antidepressants in patients with recurrent forms of severe anxiety or depressive disorders support their use in those individuals with these disorders, who experience suicidal thoughts or behavior. In general, it is assumed that antidepressants...

  • ACNP Task Force Report on SSRIs and Suicidal Behavior in Youth. Mann, J. John; Emslie, Graham; Baldessarini, Ross J.; Beardslee, William; Fawcett, Jan A.; Goodwin, Frederick K.; Leon, Andrew C.; Meltzer, Herbert Y.; Ryan, Neal D.; Shaffer, David; Wagner, Karen D. // Neuropsychopharmacology;Mar2006, Vol. 31 Issue 3, p473 

    This Task Force report by the American College of Neuropsychopharmacology evaluates the safety and efficacy of selective serotonin reuptake inhibitor (SSRIs) antidepressants for depressed youth under 18 years. The report was undertaken after regulatory agencies in the United States and United...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics