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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 27. Go back in thread:
Posted by Violet132 on September 15, 2004, at 19:43:13
In reply to Suicide and Antidepressents, posted by uther on September 15, 2004, at 18:50:51
I totally believe that only truly violent people commit suicide. I dont know if theyre depressed, orthey lost a job an dlive on the street, can't see their kids, whatever the fact may be. I have been diagnosed biopolar, OCD, Social anxiety disorder.... but I have never had suicidal thoughts. Sure, at times you want to give up. I went to my dr today pdoc? I think. And he said Oh youve been on every med that ther is and nothing has helped. I told him Yeah but i was allergic to this one YOU HAVE TO STAY OPTIMISTIC. i MEAN YOU ONLY GET ONE LIFE, (AS FAR AS i KNOW, NO oNE CAME DOWN and told me otherwise) In MY opinion, (and Im sure some people dont agree with me) it takes a very violent person to commit suicide as it takes the same kind of person to commit homicide.Either way, youre taking a life. whether yours or someone elses. I myself so far dont see things being so bad that I would want to put my family and other loved ones through the pain of seeing me lying in a coffin and giving their last respects. I have too much love for my family whether I have love for myself or not. I clouldnt do that to them. Please feel the same , love yourself (as Jesus has loved you))(if youre catholic , or religious at all) and you will pullthrough.
God luck buddy
Love YOU
Posted by mike lynch on September 15, 2004, at 19:48:15
In reply to Re: Suicide and Antidepressents, posted by Violet132 on September 15, 2004, at 19:43:13
> I totally believe that only truly violent people commit suicide.
What??? FIrst off it's been clinically proven that suicide thoughts increase in those who take ssri's..this leads to teh action..so are you saying the drugs also make people violent?? I don't know HOW you come to this conclusion that people who commit suicide are violent?? I truely dont...if anything it's the complete opposite....
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.
Posted by Glydin on September 15, 2004, at 21:40:56
In reply to Re: Suicide and Antidepressents, posted by Violet132 on September 15, 2004, at 19:43:13
> I totally believe that only truly violent people commit suicide.
I totally disagree with that statement. Suicide is more about desparation than violence, in my opinion.
I'm sure what to really make of these "new findings". I also notice the lack of a key fact that is sometimes overlooked: Suicide in "treated" persons sometimes occur when there is a beginning lifting (maybe ever so slight) of the depression.....that can be the time of the highest risk. The actually physical energy to complete is there and the emotional "bad" stuff is still present.
Posted by Ilene on September 15, 2004, at 23:31:33
In reply to Suicide and Antidepressents, posted by uther on September 15, 2004, at 18:50:51
> My take on this is the whole thing has been sensationalized(is that the right word?) by the media.
>
> Fact:
> Depressed people sometimes commit suicide
> Then whouldn't make sence that depressed people who recently started an AD may commit suicide?
>
> I think there is NO factual basis for the claim that AD increase risks of suiicide. Its all media sensationalismIt could be, depending on the medium, but what I have read has been well-reported. These findings refer to children, which makes them more newsworthy. It seems clear that certain ADs increase the risk of suicidal ideation but not necessarily completed suicide.
Posted by cache-monkey on September 16, 2004, at 0:13:56
In reply to That argument has been made before » uther, posted by Racer on September 15, 2004, at 20:02:05
<< 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. >>To follow up on this: It is unfortunate, but not infrequent for people suffering from depression to have their thoughts drift toward suicide. There are usually social and moral checks that prevent this from becoming anything more than loose contemplation. But another thing that might serve as a check on acting on a suicidal impulse is the depression itself. It would have to take a lot of energy and drive to go through with something as drastic as that.
I think that when an antidepressant starts working (assuming it does), one of the first things that happens is that people start having more motivation and energy. But it takes a little while for the thought patterns to catch up. I.e. to realize at a higher level of cognition that you're *not* depressed, useless, and whatever other negative self-stereotypes that constitute and amplify our depressions.
As a result for some the may be this limbo period in which they might still have their suicidal ideation and actually have the energy to act on it. (I think this is -- to an extent -- what Elizabeth Wurtzel descibes in her memoir _Prozac Nation_.) And this is probably especially the case for the SSRIs, given how much faster they work as a class of drugs. For slower-acting drugs, there's more time for the thoughts to catch up with feelings.
What I'm saying is that for some a temporary increased drive toward suicide might be paradoxically a part of the recovery process. This is not to say that there isn't a drug-specific causal effect -- I think there are studies that show an increase in suicidual ideation and behaviour in otherwise "healthy" (whatever that means) people given SSRI treatment.
But, if anything, this speaks to needing to have a greater awareness of treatment-emergent suicidal tendencies, as well as support systems to help people _live_ through them.
That being said, I don't think that has been the goal of the stories in the media dealing with this phenomenon. Instead, I think the media is engaging in sensationalism-as-usual. Which is unfortunate, given the general lack of understanding (and often downright stigmatizing) of depression in a large segment of our society.
peace,
cache-monkey
Posted by mike lynch on September 16, 2004, at 1:03:59
In reply to Re: Suicide and Antidepressants » Racer, posted by cache-monkey on September 16, 2004, at 0:13:56
I was moderately depressed..and was in no way experiencing any suicidal thoughts at this point..that is until about 2-3 weeks into SSRI'S.. treatmen Along with suicidal thoughts I was getting these really strange thoughts during that time period that I would just suddenly contemplate ( I remember one instance of having the sudden urge to jump out of a moving car...I mean really really wierd)
After that it's fine..but suicidal idealation with SSRI's is very real...just think about someone who's thinking about suicide before.treatment .but not severe enough to follow through with it..then they pop a pill and it just pushes them over the edge..
Posted by Camille Dumont on September 16, 2004, at 1:18:57
In reply to Suicide and Antidepressents, posted by uther on September 15, 2004, at 18:50:51
There are statistical methods to differentiate the effects of two given factors. Those studies are not simply based on observing wether two factors are correlated (i.e. suicide and ADs). That is what econometrics are for.
Posted by Emme on September 16, 2004, at 8:53:19
In reply to Re: Suicide and Antidepressents, posted by Camille Dumont on September 16, 2004, at 1:18:57
Larry Hoover actually read one of the reports not too long ago, not just articles in the media. He had some interesting things to say about it. I'm thinking of one particular thread in which he commented about the way reponses to the meds were measured and recorded. I just looked quickly and can't find it at the moment.
IMHO, the primary issue is not so much whether some people experience increased suicidality on any of the SSRIs, but rather an issue of pharmacologic management. Patients should be monitored very closely when starting drugs in case such a reaction emerges. To assume *any* psychotropic medication is beign enough to prescribe without careful followup is dangerous.
I must strenuously disagree that people who commit suicide are always violent by nature. Suicide is what happens when coping skills are outweighed by despair.
Posted by Larry Hoover on September 16, 2004, at 11:03:30
In reply to Re: Suicide and Antidepressents, posted by Emme on September 16, 2004, at 8:53:19
> Larry Hoover actually read one of the reports not too long ago, not just articles in the media. He had some interesting things to say about it. I'm thinking of one particular thread in which he commented about the way reponses to the meds were measured and recorded. I just looked quickly and can't find it at the moment.
>
> IMHO, the primary issue is not so much whether some people experience increased suicidality on any of the SSRIs, but rather an issue of pharmacologic management. Patients should be monitored very closely when starting drugs in case such a reaction emerges. To assume *any* psychotropic medication is beign enough to prescribe without careful followup is dangerous.
>
> I must strenuously disagree that people who commit suicide are always violent by nature. Suicide is what happens when coping skills are outweighed by despair.I think this was the thread Em was talking about:
http://www.dr-bob.org/babble/20040825/msgs/382578.htmlHere are a few posts I made to Usenet on the subject. If you follow the threads, there can be substantial ad hominem or uncivil content. Just a warning.
Sometimes, a picture is worth more than a thousand words. Here's a link to a graph of US suicide rates over many years. Since the advent of SSRIs around 1990, and the huge increase in both the variety of and prescriptions for these drugs, suicide rates are falling. That does not mean, of course, that there is not a treatment-emergent or withdrawal-related increase in suicidal ideation or action. But that is not unique to SSRIs. It seems to be a characteristic of all antidepressants, with the exception of Remeron. Tricyclics may be worse than SSRIs, but nobody's running around screaming about pulling those off the market.
http://www.afsp.org/statistics/USA.htm
Lar
Posted by Larry Hoover on September 16, 2004, at 11:31:48
In reply to Re: Suicide and Antidepressents » Emme, posted by Larry Hoover on September 16, 2004, at 11:03:30
Posted by SLS on September 16, 2004, at 15:08:10
In reply to Re: Suicide and Antidepressents » Emme, posted by Larry Hoover on September 16, 2004, at 11:03:30
> It seems to be a characteristic of all antidepressants, with the exception of Remeron
Hi Larry.Why have you singled-out Remeron as being without the potential to produce treatment-emergent suicidality?
Remeron exacerbated my depression. While I didn't become suicidal on it, I do believe that had I been in a despairing state before starting it, I easily could have. Another NE alpha-2 antagonist, idazoxan, affected me the same way.
- Scott
Posted by Larry Hoover on September 16, 2004, at 15:40:05
In reply to Re: Suicide and Antidepressents » Larry Hoover, posted by SLS on September 16, 2004, at 15:08:10
> > It seems to be a characteristic of all antidepressants, with the exception of Remeron
>
>
> Hi Larry.
>
> Why have you singled-out Remeron as being without the potential to produce treatment-emergent suicidality?
>
> Remeron exacerbated my depression. While I didn't become suicidal on it, I do believe that had I been in a despairing state before starting it, I easily could have. Another NE alpha-2 antagonist, idazoxan, affected me the same way.
>
>
> - ScottFrom the Table 1 data in the August 2004 FDA review:
http://www.fda.gov/ohrms/dockets/ac/04/briefing/2004-4065b1-11-TAB09a-Mosholder-review.pdfThe confidence interval is quite large, but the trend seems pretty obvious. I didn't want to damn a drug that may be an exception.
Lar
Posted by uther on September 16, 2004, at 17:33:40
In reply to Re: Suicide and Antidepressents, posted by mike lynch on September 15, 2004, at 19:33:41
Hey mike, your right i am not really that informed on this subject with regards to the studies and such.
Maybe there is a link. I base my belief on my own experiences with depression and AD's. Been on Paxil twice and effexor currently.
I dont want to stir up any heated debates or emotions or dredge up past arguments. Ive been reading these boards for years now, but have just recently got the courage to post. This place is seems like a life savior. Because I know, we know that we are all not alone.
My problem really is with the way the media portrays it. But I'll save my comments on the media for somewhere else...
I have had suicidal thoughts before AD's and while on them. However, In my case i know they didn't stem from the med.
I dont know, I feel kinda bad now starting this thread as it seems to be an emotional one. And i sensed in your original post something that stirred up some strong emotional feelings.
Take Care,
Adam< I have experienced it and I am conscience <ofthe fact that it is the drugs..i'm sure many <others do to... Maybe it is over <exxagerated..but it's just not right to say <it's not true..
Posted by RWF on September 16, 2004, at 17:46:58
In reply to Re: Suicide and Antidepressents, posted by mike lynch on September 15, 2004, at 19:48:15
How can anyone really be sure that Antidepressants don't inhibit Suicide in Depressed Patients?
Scientists themselves aren't even sure how the AD's work, they just have theories. That is all. There is no exact test for depression that includes the chemicals of your brain. If there were then we could assume that depression was in fact caused by a chemical imbalance.
The fact of the matter is that we can be depressed because of our surroundings too. Should we take a pill for that?
I have been on Effexor XR, went through the withdrawals from hell, and now I am no longer the same person that I was before...in fact I am more depressed than I ever was before.
I can't knock the drugs because for some people they help, and others they push over the edge.
Tell me something...How come it is legal to buy, sell, and consume a mind altering pill made by Eli Lilly, Wyeth-Hurst, Merck, or another of the leading drug companies that may cause suicide or homicide as a side effect but I cannot buy a substance like marijuana that has no side effects and is found to be quite soothing for Anxiety and Depression? It's all about the Government and their money.
So if you think that because the FDA says that a drug is great for depression and cannot possibly make a human being go over the edge and do the "unthinkable"...perhaps we should consider the many cases that have erupted over the past couple of years regarding "Healthy" people just killing themselves for no reason.
Come to think of it...Don't people do that on Acid and Crack-Cocaine too? Perhaps the FDA Should legalize that also.
It's a game to these people...A business that gains revenue constantly while preying upon the weak minded. If you tell someone constantly that they are depressed and anxious...in time it will kill their ability to fight off such feelings.
So take the pill or don't...it's really up to you.
Posted by Sebastian on September 16, 2004, at 20:34:23
In reply to Suicide and Antidepressents, posted by uther on September 15, 2004, at 18:50:51
I think people feel labeled with a mental illness and the proof is when they have to take meds. This makes them suicidal because they are now depressed with a mental illness, depression from the depression. Not to mention the different feeling of when on a medication.
Just a theory. Based on my depression from having to take meds for my illness all these years. Needing to take meds is depressing.
Posted by Sebastian on September 16, 2004, at 20:37:17
In reply to Re: Suicide and Antidepressents, posted by RWF on September 16, 2004, at 17:46:58
Knowing your brain doesen't work is a depressing thing.
Posted by CatFanatic on September 16, 2004, at 20:54:02
In reply to Suicide and Antidepressents, posted by uther on September 15, 2004, at 18:50:51
Depressed people who drink water, or bathe, or do other things that are health and beeficial also commit suicide. I guess the whole point is that depression is very serious and there aren't such things as magic pills that the drug companies would lead us to believe. Fro mthe commercials on tv, you would ge the impression is all one has to do to get better is take some of their overexpensive pills, an now you are happy.
Why are these drugs, ie ssris legal, but marijuana isn't? Does marijuana use in depressed peole cause suicide?
Posted by Ilene on September 16, 2004, at 22:21:16
In reply to Suicide and Antidepressents, posted by uther on September 15, 2004, at 18:50:51
Hey folks--remember that these findings apply to children and adolescents only, and they don't apply to all ADs. For example, prozac seems to be okay for kids to take.
Posted by uther on September 20, 2004, at 18:10:40
In reply to Re: Suicide and Antidepressents, posted by Ilene on September 16, 2004, at 22:21:16
AD's DONT CURE DEPRESSION.
They relieve symptoms of depression, thus helping a person overcome the situation or problem causing the depression.Thats what i think.
And thats why i think AD poop out on people. They relieve your symptoms, you feel like a new person. But you havn't changed or fixed your underlying problem. thus after a while the initial depression returns.
Posted by uther on September 20, 2004, at 18:24:17
In reply to AD's DO NOT Cure depression, posted by uther on September 20, 2004, at 18:10:40
I have been on paxil twice, and now effexor, have taken lorazapam, ativan, clonazapam, and take trazodone to sleep.(Cause I haven't been able to have natural sleep in over 5 years.
These medication are not going to cure me. They are not going to fix my problems, make me a happy person, make me a social person, make me able to pic the phone up when someone calls, or ask a gal out on a date, or stop myself from telling myself i am a looser, a failer, unworthy...
But
They hopefully they will help those negative feelings subside, and lesson, so i can work on the real problems in my life. The reasons WHY i feel these things.Im sorry, Im rambling, maybe not even making sense.
Its just i cant talk to anyone about my feelings.
just my pdoc, and i cant even tell him what i feel deep down in the darkness of my soul.This ramble doesnt even really fit in this thread...
But here, I can talk about these things. Everyone here is like me. Maybe not the same problems, we may not have the same view points, like the initial AD and suicide post i made)
But we are all here to support each other cause we all been through it.I just with i had the courage to post here 4 years ago when i started reading this forum.
So, thanks for listening to my ramble.
Take Care
Adam
Posted by FredPotter on September 21, 2004, at 16:23:27
In reply to What AD do, posted by uther on September 20, 2004, at 18:24:17
Has anyone heard of "Human Givens Therapy"? I realise this should be diverted, but the subject arose in the context of ADs. They say that if you're depressed your life isn't working. We have basic requirements that are not being met, eg intimacy (not sex necessarily), a sense of belonging to the wider community, a sense of security and of purpose etc. The breakup of extended families since the war has increased the occurrence of depression.
This is the the idea, but it's difficult to get some of these requirements met when you're afraid to go out for example. A key person in all this is Joe Griffin. I don't necessarily believe any of this and I would think ADs have a role at least in getting you started
Fred
Posted by Dr. Bob on September 22, 2004, at 16:39:22
In reply to Re: What AD do » uther, posted by FredPotter on September 21, 2004, at 16:23:27
> Has anyone heard of "Human Givens Therapy"? I realise this should be diverted...
I think so, too, here's a link:
http://www.dr-bob.org/babble/psycho/20040918/msgs/393772.html
Thanks,
Bob
Posted by Violet132 on September 23, 2004, at 16:39:52
In reply to Re: Suicide and Antidepressents, posted by mike lynch on September 15, 2004, at 19:48:15
Okay, I guess I WAS a little to judgemental. Never having suicidal thoughts of my own, I can't understand how people get that into dying, whether they're taking their life or someone elses. What I meant by that was how can you take your own life? If you could, are you capable of doing the same to another human? I understand that people get depressed. I am one of them. Saying that meds can make you suicidal is true, in some cases. But med's have many different effects on people. Some people as I stated before take their own life because they lost a job, or a house,...etc. They probably aren't on meds right? So they just gave up because of one thing that went wrong. I just think that saying that the meds made him do it is a cop-out in some cases. (It's my opinion and I know many will disagree completely) but people can't give up hope when something goes wrong or 90% of people will be committing suicide. SUICIDE IS A PERMANENT SOLUTION TO A TEMPORARY PROBLEM!! No ifs ands or buts.
I didn't mean to cause such a stir of emotions. I am very sorry for that.
Posted by paulbwell on September 26, 2004, at 19:30:38
In reply to Re: Suicide and Antidepressents mikelynch » mike lynch, posted by Violet132 on September 23, 2004, at 16:39:52
> Okay, I guess I WAS a little to judgemental. Never having suicidal thoughts of my own, I can't understand how people get that into dying, whether they're taking their life or someone elses. What I meant by that was how can you take your own life? If you could, are you capable of doing the same to another human? I understand that people get depressed. I am one of them. Saying that meds can make you suicidal is true, in some cases. But med's have many different effects on people. Some people as I stated before take their own life because they lost a job, or a house,...etc. They probably aren't on meds right? So they just gave up because of one thing that went wrong. I just think that saying that the meds made him do it is a cop-out in some cases. (It's my opinion and I know many will disagree completely) but people can't give up hope when something goes wrong or 90% of people will be committing suicide. SUICIDE IS A PERMANENT SOLUTION TO A TEMPORARY PROBLEM!! No ifs ands or buts.
> I didn't mean to cause such a stir of emotions. I am very sorry for that.
>"SUICIDE IS A PERMANENT SOLUTION TO A TEMPORARY PROBLEM"-Bill Ward,
Drummer for 'Black Sabbath'-Greatest Rock Band ever,
Three time, Suicide atemptee, after Cocaine and Alcohol, addiction-Insanity
This is the end of the thread.
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