BMJ  2005;330:1149-1150 (14 May), doi:10.1136/bmj.330.7500.1149-b

Letter

Do selective serotonin reuptake inhibitors cause suicide?

Data seem to be incorrect

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

EDITOR—Fergusson et al report that the risk of suicide attempts is significantly greater for patients enrolled in short term randomised controlled trials of selective serotonin reuptake inhibitors (SSRIs) than with placebo (odds ratio 2.28, P < 0.02) and other interventions (not including tricyclics) (odds ratio 1.94).¹ They are also one of the few groups to report that completed suicides (fatal attempts) were also higher with SSRIs than tricyclics (odds ratio 7.27 [corrected to 1.08 (0.28 to 4.09), see correction, 19 March, p 653]). This seems to have led Cipriani et al to say that there is almost a double risk of fatal and non-fatal risk of suicide for people taking SSRIs.²

An increased risk of fatal overdoses when using SSRIs is hard to understand, particularly when the comparison is tricyclics, given their acknowledged toxicity in overdose.^3-5 I therefore rechecked the odds ratios from the data given by . . . [Full text of this article]

Leicester General Hospital, Leicester LE5 4PW alex.mitchell@leicspart.nhs.uk

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