Do selective serotonin reuptake inhibitors cause suicide?: Authors' reply to Curtin and Schulz, and Healy

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David Gunnell, professor of epidemiology (D.J.Gunnell@bristol.ac.uk),
Julia Saperia, research assistant,
Deborah Ashby, professor of medical statistics

Department of Social Medicine, University of Bristol, Bristol BS8 2PR
Wolfson Institute of Preventive Medicine, Queen Mary, University of London, London EC1M 6BQ

EDITOR—We agree with Curtin and Schulz that drug induced motor disinhibition before mood improvement is a possible explanation for an excess of suicidal behaviour in the early weeks of antidepressant treatment.1 2

Regarding their second point, we caution against over-interpreting differences in the pooled odds ratios for self harm and suicidal thoughts or the odds ratios for different selective serotonin reuptake inhibitors (SSRIs) in relation to the same end points. Odds ratios are …