Lines of evidence on the risks of suicide with selective serotonin reuptake inhibitors.
نویسنده
چکیده
BACKGROUND There has been a long-standing controversy about the possibility that selective serotonin reuptake inhibitor (SSRI) antidepressants might induce suicidality in some patients. METHODS Starting from the clinical studies that gave rise to this issue, this paper reviews an unselected cohort of randomized clinical trials (RCTs), a series of meta-analyses undertaken to investigate aspects of the problem, studies in recurrent brief depressive disorders, epidemiological studies and healthy volunteer studies using SSRIs to shed light on this issue. RESULTS The original clinical studies produced evidence of a dose-dependent link, present on a challenge, dechallenge and rechallenge basis, between SSRIs and both agitation and suicidality. Meta-analyses of RCTs conducted around this time indicate that SSRIs may reduce suicidal ideation in some patients. These same RCTs, however, yield an excess of suicides and suicide attempts on active treatments compared with placebos. This excess also appears in the best-controlled epidemiological studies. Finally, healthy volunteer studies give indications that SSRIs may induce agitation and suicidality in some individuals. CONCLUSIONS The data reviewed here, which indicate a possible doubling of the relative risk of both suicides and suicide attempts on SSRIs compared with older antidepressants or non-treatment, make it difficult to sustain a null hypothesis, i.e. that SSRIs do not cause problems in some individuals to whom they are given. Further studies or further access to data are indicated to establish the magnitude of any risk and the characteristics of patients who may be most at risk.
منابع مشابه
Effect of Donepezil on Cognitive Disorders Due to the Selective Serotonin Reuptake Inhibitors in the Patients with Major Depressive Disorder
Introduction: Many factors cause cognitive impairment, including medication, such as selective serotonine reuptake inhibitor drugs use. On the other hand, many drugs are used in cognitive impairment therapy, including donepezil, which act by inhibiting the cholinesterase enzyme and increase brain acetylcholine. Methods: This study was a double-blind controlled randomized controlled clinical tr...
متن کاملMyoclonus as a Single Side Effect of Combination of Selective Serotonin Reuptake Inhibitors (SSRIs) and Clomipramine: Three Case Reports
Selective Serotonin Reuptake Inhibitors (SSRIs) are the most popular psychiatric medications that are approved for several neuropsychiatric conditions such as depression and obsessive-compulsive disorder (OCD). On the other hand, clomipramine is a tricyclic anti-depressant which is the only approved medication, among this class, to treat OCD due to its substantial effects on serotonergic sys...
متن کاملForensic database study suggests selective serotonin reuptake inhibitors do not increase the risk of suicide in people taking antidepressants.
Isacsson G, Holmgren P, Ahlner J. Selective serotonin reuptake inhibitor antidepressants and the risk of suicide: a controlled forensic database study of 14,857 suicides. Acta Psychiatr Scand 2005;111:286–90. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...
متن کاملMeta-analysis of Selective Serotonin Reuptake Inhibitors (SSRIs) Compared to Tricyclic Antidepressants (TCAs) in the Efficacy and Safety of Anti-depression Therapy in Parkinson᾽s Disease(PD) Patients
This meta-analysis aims to assess the efficacy and safety of SSRIs and TCAs in treatment of PD. A computer-base search was conducted of Pubmed, MEDLINE, EMBASE, Cochrane Controlled Trails Register (CCTR) up to December 2011. The random controlled clinic trials about SSRIs and TCAs in PD treatment were collected. Statistical analysis was completed using Review Manager, version 5.0. Five clinic c...
متن کاملThe risk of suicidality with selective serotonin reuptake inhibitors.
Antidepressants are efficacious in the treatment of depression but they are not without side effects. The recent findings on the risk of suicide with selective serotonin reuptake inhibitor treatment, however, have raised serious concerns about the risk-benefit ratio of their use. The development of the concerns is traced and the risks discussed, particularly in the child and adolescent group. T...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Psychotherapy and psychosomatics
دوره 72 2 شماره
صفحات -
تاریخ انتشار 2003