BMJ  2004;329:461 (21 August), doi:10.1136/bmj.329.7463.461-a

Letter

Antidepressants and suicide

Risk of completed suicide is not the same as risk of deliberate self harm

The first 150 words of the full text of this article appear below.

EDITOR—I welcome Gunnell and Ashby's timely review on the risks versus benefits of selective serotonin reuptake inhibitors (SSRIs),¹ but I am not sure how much this article clears the air.

The authors take adverse "suicide related event" data reported by the Medicines and Healthcare Products Regulatory Agency (largely over-arousal, suicidal thoughts, and self harm) explicitly to mean completed suicide. Although no actual suicides occurred in the agency's data, the authors multiply an estimate of completed suicides per year in those taking antidepressants by the relative risk (incorrectly stated as "odds ratio" in table 1) of suicide related events to calculate what is claimed to be an excess number of completed suicides attributable to antidepressants. Even if both figures that they quote were correct, the final figure would be the excess of deliberate self harm in the worst case and over-arousal in the best case (but more likely a . . . [Full text of this article]

Leicester General Hospital, Leicester LE5 4PW Alex.Mitchell@leicspart.nhs.uk

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Relevant Article

Antidepressants and suicide: what is the balance of benefit and harm

David Gunnell and Deborah Ashby
BMJ 2004 329: 34-38. [Extract] [Full Text] [PDF]