Antidepressants and suicide

doi:10.1136/bmj.39482.666366.80

BMJ 2008;336:515-516 (8 March), doi:10.1136/bmj.39482.666366.80 (published 14 February 2008)

Editorials

Antidepressants and suicide

Treatment is probably too sporadic to affect overall suiciderates

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

Two accompanying observational studies by Biddle and colleaguesand Wheeler and colleagues add to the recent literature regardingchanges in antidepressant use and changes in suicide rates.¹² The current controversy began in2003,whenreanalyses of datafrom clinical trials raised concerns that antidepressants mightprecipitate suicidal thoughts or attempts at suicide. Childrenand adolescents starting treatment with several newer antidepressantshad a 4% risk of developing suicidal ideation or behaviour,compared with 2% in those receiving placebo.³ However, clinicaltrials cannot determine whether antidepressants increase ordecrease the risk of genuine suicide attempts or death fromsuicide because these outcomes are, fortunately, too rare. Nodeaths from suicide and few attempts at suicide have occurredto date in trials of antidepressants in adolescents,³ so anyclinical trial that could reliably assess effects on death fromsuicide would require several times more participants than havebeen included in all such trials to date.

. . . [Full text of this article]

Gregory Simon, investigator

¹ Center for Health Studies, Group Health Cooperative, Seattle, WA 98112, USA

Simon.g@ghc.org

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