Posted by Racer on September 15, 2004, at 20:02:05
In reply to Suicide and Antidepressents, posted by uther on September 15, 2004, at 18:50:51
In fact, that's probably the most commonly used argument against any link between SSRIs and suicide.
Yes, there is a correlation between depression and suicide. That's hardly controversial.
Is there an increased risk of suicide while taking anti-depressants? Probably, and for a number of psychological reasons as well as any possible drug effects. For one thing, these drugs often take a while to kick in, so someone suffering severe depression who has had suicidal impulses may simply give up hope too quickly. Someone whose depression is not yet alleviated who experiences adjustment phase side effects may also give up, because of the discomfort.
On the other hand, the agititation caused by some of these agents has been targetted as the most likely cause of an increased risk of suicidal behavior. Someone who's experienced a vegetative depression may suddenly experience overwhelming agitation, without any relief from the depression, which may indeed increase that person's risk for suicidal behavior. Similarly, someone who experiences the agitation as distressing may also engage in such behavior, whether or not the medication addresses depression.
There are so many factors involved that I believe it will be a long time before any truly definitive answer is found regarding the mechanism for the increased suicidality on anti-depressants, particularly the SSRIs. The evidence so far, however, does indeed support the view that psychopharmacotherapy for depression increases the risk of suicide. That evidence, I'm afraid, is also incontrovertable. Even the studies done by the drug companies and submitted to the FDA show that suicidal behavior increased in those patients on the drugs -- behavior which was conveniently (for the drug companies) labelled with misleading descriptions, such as "emotional lability".
I agree that the media is blowing this story out of proportion. These drugs are life savers in every sense to people who need them. They are still very powerful, very serious drugs, with a range of action which may not be sufficiently well understood as yet. Perhaps the best solution, until those actions are fully understood, is to balance the sensationalisism in the media of the suicide risk against the DTC advertising of the drugs companies, and agree to treat all psychiatric (and, for that matter, ALL) medications with proper respect.
poster:Racer
thread:391220
URL: http://www.dr-bob.org/babble/20040915/msgs/391250.html