Posted by SLS on October 12, 2015, at 20:10:07
That antidepressants can produce suicidal states as an adverse effect, especially in young people, is observable. However, I am not sure of at what rates this happens. Still, it is clear that antidepressants have a place in the treatment of mood disorders, and that the risk/benefit ratio favors their use in the majority of cases.
I found an interesting article that differentiates between acute and chronic antidepressant exposure and the possible involvement of serotonin 5-HT1a receptor activity in SSRI-induced suicidality.
http://www.ncbi.nlm.nih.gov/pubmed/25942044
I don't know why the investigators didn't use pindolol as a 5-HT1a receptor antagonist to prevent SSRI induced suicidality. It is readily available and cheap. If the article is accurate, then one might be able to use pindolol during the critical window early in treatment when a suicidal state is more apt to emerge. It can then be tapered and discontinued. Just a thought.
The authors suggest that starting young people at very low dosages of antidepressants, and titrating very gradually might reduce the risk of drug-induced suicide. I hope more study will be conducted in this area.
These are some of the things I see:
1. The overall rate of suicide of young people has decreased with the use of antidepressants.
2. Drug-induced suicidality occurs more often in young people than in adults.
3. Drug-induced suicidality is more likely to occur early in treatment.
4. Strict monitoring for the emergence of suicidality early in treatment should be the standard of care for every patient.
Any comments?
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1083394
URL: http://www.dr-bob.org/babble/20150929/msgs/1083394.html