Citation

Sussman N. Prim. Psychiatry 2009; 16(9): e14.

Copyright

(Copyright © 2009, MBL Communications)

DOI

unavailable

PMID

unavailable

Abstract

By now, most readers of Primary Psychiatry are familiar with the October 2003 alert by the Food and Drug Administration Public Health Advisory citing the risk of suicidality for pediatric patients taking antidepressants. In February 2005, the FDA went further, asking that antidepressant product information contain a black box warning to that effect. In May 2007, the warning was extended to young adults 18-24 years of age. Even before the actual warnings were added to the medications, declines in patients being diagnosed with depression were observed, as was a decrease in the prescription of selective serotonin reuptake inhibitors (SSRIs). The drop in prescriptions for SSRIs extended to adult patients, a group not found to be at increased risk for suicide with antidepressants and a group not cited in the warnings. A new analysis1 by investigators at the Center for Drug Evaluation and Research confirms that patients under 25 years of age who take antidepressants do have a higher risk of suicide, and those above that age do not. The investigators concluded that risk of suicidality associated with antidepressant use is strongly age dependent. "Compared with placebo, the increased risk for suicidality and suicidal behavior among adults under 25 [years of age] approaches that seen in children and adolescents. The net effect seems to be neutral on suicidal behavior but possibly protective for suicidal ideation in adults aged 25-64 [years] and to reduce the risk of both suicidality and suicidal behavior in those aged ≥65 [years]." For participants with non-psychiatric indications, suicidal behavior and ideation were extremely rare. © MBL Communications Inc.

Language: en

Keywords

human; suicide; psychotherapy; suicidal ideation; depression; suicidal behavior; clinical trial; risk factor; review; prescription; antidepressant agent; anxiolytic agent; serotonin uptake inhibitor; treatment indication; drug safety; placebo; food and drug administration; drug efficacy; drug screening; drug information; high risk patient; cohort analysis; atypical antipsychotic agent; serotonin noradrenalin reuptake inhibitor