Do selective serotonin reuptake inhibitors cause suicide?: Discrediting old drugs may be useful in marketing new ones

doi:10.1136/bmj.330.7500.1149

BMJ 2005;330:1149 (14 May), doi:10.1136/bmj.330.7500.1149

Letter

Do selective serotonin reuptake inhibitors cause suicide?

Discrediting old drugs may be useful in marketing new ones

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

EDITOR—Fergusson et al report the association betweensuicide attempts and use of selective serotonin reuptake inhibitors(SSRIs).¹ A causal link between use of an SSRI and self harmwould have drastic clinical implications for health services.The extra monitoring might make using antidepressants whollyimpractical in a risk averse service.

The reported incidence of self harm in these studies, with estimatesof 0.05-0.001%, is remarkably low. Even during a short trial,such a low incidence among patients with severe depression isnot credible. The surely unique finding that rates of fataland non-fatal self harm are identical among placebo treatedpatients further emphasises how unsustainable these reportedfigures must be. It is perhaps unsurprising that in studiesdesigned to evaluate not self harm but efficacy, acts of selfharm will be under-reported.

Under-reporting is likely to be more common among placebo treatedpatients. Although the methods of self . . . [Full text of this article]

Hugh M Jones, consultant psychiatrist

Lordship Lane Community Mental Health Team, London SE22 8HN hugh.jones@slam.nhs.uk

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Association between suicide attempts and selective serotonin reuptake inhibitors: systematic review of randomised controlled trials: Dean Fergusson, Steve Doucette, Kathleen Cranley Glass, Stan Shapiro, David Healy, Paul Hebert, and Brian Hutton
BMJ 2005 330: 396. [Abstract] [Full Text] [PDF]