Selective serotonin reuptake inhibitors

doi:10.1136/bmj.329.7470.809

BMJ 2004;329:809-810 (9 October), doi:10.1136/bmj.329.7470.809

Editorial

Selective serotonin reuptake inhibitors

Remain useful drugs which need careful monitoring

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

The increasing use of antidepressants—particularly theselective serotonin reuptake inhibitors (SSRIs)—mightbe grounds for optimism because it might indicate that one ofthe great health problems of our age is increasingly being recognisedand treated. Instead SSRIs have become embroiled in controversyover both their effectiveness and safety. As well as the doubtsabout efficacy, the media have fuelled concern that SSRIs maycause serious adverse effects, ranging from worsening depressionto suicide. The scientific evidence shows that the media hasblown the risk of suicide out of proportion.

The increase in prescribing of SSRIs has coincided with a fallin the suicide rate in many countries, implying that SSRIs arenot a major cause of suicide.¹ Case-control studies—whichcannot completely rule out confounding by indication—probablyexclude a substantial increase in both relative and absoluterisk of suicide.² A meta-analysis of individual patient datafrom the randomised trials is clearly . . . [Full text of this article]

John R Geddes, professor of epidemiological psychiatry

(john.geddes@psych.ox.ac.uk) University of Oxford, Warneford Hospital, Oxford OX10 0RU

Andrea Cipriani, research fellow in psychiatry

(andrea.cipriani@medicina.univr.it) Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy

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Geddes, J. R., Calabrese, J. R., Goodwin, G. M. (2009). Lamotrigine for treatment of bipolar depression: independent meta-analysis and meta-regression of individual patient data from five randomised trials. Br. J. Psychiatry 194: 4-9 [Abstract] [Full text]
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