[Velvet Elvis]

UCLA Study Disputes Antidepressant/Suicide Link

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Challenging recent claims linking antidepressant use to suicidal behavior, a new UCLA study shows that American suicide rates have dropped steadily since the introduction of Prozac and other serotonin reuptake inhibitor (SSRI) drugs. Published in the February edition of the journal Nature Reviews Drug Discovery, the authors caution that regulatory actions to limit SSRI prescriptions may actually increase death rates from untreated depression, the No. 1 cause of suicide.

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New Report Concludes SSRI Antidepressants Do Not Increase Suicidal behavior in Youth with Depression

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WASHINGTON -- Selective Serotonin Reuptake Inhibitors (SSRI) antidepressants do not increase the risk of suicidal thinking or suicide attempts in youth, according to a new
report released in late January by the American College of Neuropsychopharmacology
(ACNP).  The report also noted that several SSRIs have been shown to be
effective for treating depression in this population.  ACNP appointed a
special task force of the nation's leading scientists in the field to review
the available research on the use of antidepressants and youth under 18 years
of age.

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Suicide Rates Have Decreased With Increased Use of SSRIs, New-Generation Non-SSRIs

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Suicide Rates Have Decreased With Increased Use of SSRIs, New-Generation Non-SSRIs

Laurie Barclay, MD


Feb. 7, 2005 — Suicide rates have dropped in association with increased use of selective serotonin reuptake inhibitors (SSRI) and new-generation non-SSRIs, according to the results of an analysis of a U.S. Centers for Disease Control and Prevention (CDC) national vital statistics study published in the February issue of the Archives of General Psychiatry. However, the investigators acknowledge that this type of data cannot demonstrate causal relationships.

"Approximately 30,000 people die annually by suicide in the US," write Robert D. Gibbons, PhD, from the University of Illinois at Chicago, and colleagues. "Although 60% of suicides occur during a mood disorder, mostly untreated, little is known about the relationship between antidepressant medication use and the rate of suicide in the US."

Using data from all US individuals who committed suicide between 1996 and 1998, the investigators extracted national county-level suicide rate data broken down by age, sex, income, and race. They also determined national county-level antidepressant prescription data, expressed as the number of pills prescribed. The main outcome was the suicide rate in each county expressed as the number of suicides for a given population size.

After adjustment for age, sex, race, income, and county-to-county variability in suicide rates, antidepressant medication prescription was not significantly related to suicide rate. However, within individual classes of antidepressants, prescriptions for SSRIs and other new-generation non-SSRI antidepressants, such as nefazodone hydrochloride, mirtazapine, bupropion hydrochloride, and venlafaxine hydrochloride, were associated with lower suicide rates, both within and among counties. There was a positive association between tricyclic antidepressant (TCA) prescription and suicide rate. In rural areas, higher suicide rates were associated with fewer antidepressant prescriptions, lower income, and relatively more prescriptions for TCAs.

"The aggregate nature of these observational data preclude a direct causal interpretation of the results," the authors write. "A high number of TCA prescriptions may be a marker for those counties with more limited access to quality mental health care and inadequate treatment and detection of depression, which in turn lead to increased suicide rates. By contrast, increases in prescriptions for SSRIs and other new-generation non-SSRIs are associated with lower suicide rates both between and within counties over time and may reflect antidepressant efficacy, compliance, a better quality of mental health care, and low toxicity in the event of a suicide attempt by overdose."

From:  http://www.medscape....e/498841?src=mp

This post has been edited by Velvet Elvis: 25 May 2005 - 03:07 PM

[Velvet Elvis]

Your Past Responses

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Posted by: stinky  Posted on: Feb 15th, 2005, 9:05pm
see i'd always suspected that!

that whole big theory seems to ignore that ssris are

1given to people who are thinking of suicide anyway

2activating and can improve motivation, including the motivation to kill oneself

3not perfect and have side effects that a desperate person might find intolerable and a reason to commit suicide.

Angry sick of people needing SOMETHING To blame while ignoring the blazing obvious fact that mental illness is an awful, potentially fatal thing to experience

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Posted by: psyche1978  Posted on: Feb 16th, 2005, 10:21am
Another thing is that many times SSRIs are prescribed by gps who generally spend no more than one month on a psychiatry rotation - it took me months to learn how to do a decent psych interview to check for suicidality and subtle mood changes (and I am not even allowed to prescribe, not that I want to, but...). A person in need of psych meds needs to have a thorough initial interview and lots of checking in during treatment - unfortunately, in many cases, that simply does not happen. They get a script and are sent along their merry way. And if something happens, the med gets blamed. Not poor practice.

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Posted by: johnny66  Posted on: Feb 16th, 2005, 5:18pm
Thanks, Velvet Elvis. Always nice to get some decent material to balance against the tabloid scare pieces.

Thankyou.  Smiley

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Posted by: Greenyflower  Posted on: Feb 16th, 2005, 6:31pm
Bravo!

V Elvis, thank you for that post. It's good to know that researchers are finally documenting what many of us intuitively know already.

My favorite line in the first article was:
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"When people start antidepressant therapy, the first symptom to be alleviated is low energy, but the feeling that life isn't worth living is the last to go," he said.


How true is that?!

Demonizing the drug instead of the whole cluster fuck of the medical system from parents to HMOs to doctors to insurance companies doesn't help anyone. ANY medication that affects neurochemistry deserves close monitoring, all the more so for children.

Greeny

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Posted by: noemie  Posted on: Feb 17th, 2005, 2:36pm
I wish someone would do a study looking at the cost to life, quality of life, and GDP (just b/c people who don't care about the former sometimes are about $$) of anti-psych meds propaganda and imbalanced media portrayals of side effects.  Both directly (upsets me when I constantly read pieces and commentary in the NY Times about how SSRIs shouldn't be given to teenagers) and through others (my friend's mother reads anti-SSRI books and then harasses her about taking Zoloft every time she goes home). 

This would be a good opportunity to call attention to how childhood, adolescent, and adult mental illnesses go unnoticed or actively ignored, are often mistreated or undertreated even when picked up on, and are often not adequately treated in the long term, partly because of societal pressure not to take medication.  Instead of focusing on how drug companies are conspiratorial and evil.  But no, we've got to go with Baby Boomer-style intrinsic distrust of The System.  That sells, and talking about how we as parents and friends are letting our friends and children suffer - or making things worse for them - doesn't.  ):

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Posted by: Jacylrin  Posted on: Feb 21st, 2005, 11:54am
Glad to know I'm not the only one pissed off at how the media is treating this whole "Zoloft made them kill themself" thing.  Every time anybody tries to feed me that crap, I remind them of the facts from the article at the beginning of the thread -

"When people start antidepressant therapy, the first symptom to be alleviated is low energy, but the feeling that life isn't worth living is the last to go," he said. "Prior to taking SSRIs, depressed people may not have committed suicide due to their extreme lethargy. As they begin drug therapy, they experience more energy, but still feel that life isn't worth living. That's when a depressed person is most in danger of committing suicide." 
 
Funny, this has been well known among psychologists for a long time.  It was part of my training in college in the early 1990's, and part of crisis intervention hotline training at the same time.  It's a LONG known fact that suicide is most likely to occur as someone is coming OUT of a depressive episode (I've always loved that irony).  You get the energy back before the mood improves.  Only makes sense that starting an antidepressant can start this cycle.  It seems that only now are the lawyers deciding to notice this fact.

I agree that doctors writing prescriptions without reading about meds - and conditions - is a large part of the problem.  Everybody wants a pill to instantly fix the problem.  Nobody wants to have to do the work to follow up, or to figure out that gee, starting to have enough motivation to do SOMETHING may be tricky.  Again, duh.

Sorry, all the media coverage has been pissing me off.  Again, happy to know I'm not the only one irritated by the coverage.

-=- Jacylrin, aka Em.

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Posted by: wakko926  Posted on: Mar 23rd, 2005, 8:51am
so what do you do if your medicine still hasn't brought you from that not wanting to live phase?

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Posted by: Dibba  Posted on: Mar 23rd, 2005, 11:09am
When my grandfather did himself in in 1972 they didn't have ssri's.  He might still be 80 something and alive today if he was on them.  A shame.

This post has been edited by Velvet Elvis: 25 May 2005 - 03:01 PM