Do selective serotonin reuptake inhibitors cause suicide?: Authors' reply to Jones, Sakinofsky and Streiner, and Mitchell

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7500.1150 (Published 12 May 2005) Cite this as: BMJ 2005;330:1150
  1. Dean Fergusson, scientist (dafergusson@ohri.ca),
  2. Steve Doucette, research associate,
  3. Paul Hebert, senior scientist,
  4. David Healy, professor,
  5. Stan Shapiro, professor
  1. Ottawa Health Research Institute, Clinical Epidemiology Program, 501 Smyth Road, Box 201, Ottawa, Ontario, Canada K1H 8L6
  2. Department of Psychological Medicine, University of Wales College of Medicine, Bangor
  3. Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada

    EDITOR—The low rates of attempted suicide may be the result of several factors. Most studies did not enrol patients at immediate risk of suicide, and 59% of studies (414/702) were conducted in clinical indications other than major depression. The greatest contributing factors may be the under-reporting and non-reporting of events. Of the 702 trials, 345 did not provide documentation on suicide attempts.

    Given the seriousness of attempted suicide, the expectation that patients in trials be well monitored, and a well documented possible association between treatment with selective serotonin reuptake inhibitors (SSRIs) and suicidality, it is disturbing that fatal and non-fatal suicide attempts were not apparently better reported. We …

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