Mental Health
SSRI Suicide Risk Differs in Age of Patient
Wall Street Journal published on December 6, 2006 the article, “FDA: Antidepressants Lessen Risk of Suicidal Thoughts for Seniors”, stating that the FDA’s review of 372 clinical study data involving 11 antidepressants had shown that antidepressants may increase suicidal risk in adolescents, but this risk decreases in but that in older adults the risk declines.
Currently antidepressants carry a black box warning (reserved for life threatening risk) on the increased risk of suicidal thinking in children and teens who have taken antidepressants. This FDA review included at least 100,000 patients who have taken antidepressants across different age groups. In fact, the FDA suggested that in adults 65 years and older, antidepressants actually had a protective effect against suicide risk. This has to be welcome news to drug companies that manufacture antidepressants, although a new labeling change may not happen anytime soon.
Discussion
2 comments for “SSRI Suicide Risk Differs in Age of Patient”
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According to Dr. Irving Kirsch in Prevention & Treatment , “there is now unanimous agreement that the mean difference between response to SSRI antidepressant drugs and response to inert placebo is very small. It is so small that, despite sample sizes involving hundreds of participants, 57% of the SSRI trials funded by the pharmaceutical industry failed to show a significant difference between drug and placebo. Most of these negative data were not published and were accessible only by gaining access to US Food and Drug Administration (FDA) documents.
Various methods were used to manipulate the results of SSRI drug studies to insure a favorable outcome:
1) Responders to the placebo are eliminated at the beginning of the study. (Placebo washout)
2) Benzodiazepine sedatives were given to mask the SSRI induced agitation.
3) Unfavorable drug studies are buried in the file cabinet and not disclosed to the public.
4) Miscoding suicidal events as “emotional lability”, and homicidal events as “aggression” to hide suicidal events from regulators.
5) False attribution of suicide to the placebo arm.
6) Hiring ghost writers to make the medical articles more favorable.
7) Cash settlements for SSRI drug litigants which seals records and withholds unfavorable drug studies from the public.
For more information and links see my Paxil, Prozac, and SSRI Induced Suicide Newsletter
Jeffrey Dach MD
Dr. Dach,
I agree with many of the points you have raised re: SSRI studies and the lack of transparency around safety issues. Given the scrutiny and investigations, I believe that there is greater transparency of safety concerns and I hope that most doctors will discuss these with their patients when prescribing SSRIs.
I visited your website and saw that you have no financial disclosure with pharmaceutical companies. Given your advocacy for herbal or nutraceutical approaches, do you have any financial affiliations or interests in nutraceutical companies or manufacturers of herbal supplements?
Also, if you don’t mind me asking, are there robustly designed, randomized-controlled clinical studies that proactively looks at the effectiveness and safety of nutraceuticals, herbal supplements, or medical foods in the treatment of depression when compared with the “traditional chemical” standards and/or compared with placebo?
My understanding is that the few clinical studies in depression looking at St. John’s Wort/Hypericum had a select patient population - those patients who suffered from mild to moderate depression, but not severe depression, and that patients who were severely depressed did not respond as well to Hypericum.
Finally, I enjoyed looking through your online art gallery.
Thanks,
jane