NEW YORK (Reuters Health) - Adults with depression who are treated with a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) have a lower rate of suicide attempts, the results of a new study indicate.
In October 2004, the U.S. Food and Drug Administration (FDA) ordered drug labeling to warn of a possible link between antidepressant drug treatment and suicidal thoughts, or "ideation," and behavior in children and adolescents, the researchers note in the American Journal of Psychiatry. In May 2007, the warning was extended to include young adults.
Dr. Robert D. Gibbons, of the University of Illinois at Chicago, and colleagues examined the association between antidepressant treatment and suicide attempts in adult patients treated in the Veterans Administration health care system.
Data were analyzed for 226,866 veterans without a history of depression as of 2000-2002, but had been diagnosed with depression by 2003-2004 and were followed for at least 6 months. The team compared the suicide attempt rates before and after the patients began treatment with SSRIs or tricyclic antidepressants.
Overall, 114,475 subjects were treated with one drug within one class of antidepressants; 72 percent received an SSRI, 24 percent received a non-SSRI and 4 percent were given a tricyclic antidepressant. Another 52,959 patients received a combination of antidepressant drugs and 59,432 were not treated.
Suicide attempt rates were lower after treatment than before treatment, the team reports. A comparison of suicide attempts before and after treatment with a single SSRI also revealed lower risk for patients in all age groups. This relationship was statistically significant in all but the 18 to 25 age group, "possibly because of the smaller number of patients in that age group in the VA population and the small number of events."
The rate of suicide attempts was also lower among patients treated with antidepressants compared with those who were not. Specifically, the overall suicide attempt rate after initiation of SSRI treatment (alone or in combination with another antidepressant) was 364 per 100,000, while the rate for all other patients with depression was 1,057 per 100,000.
Suicide attempt rates among patients who received any antidepressant, compared with untreated patients was lower for all age groups, Gibbons and colleagues found.
They conclude that SSRI treatment has a protective effect against suicide in all adult age groups --- and the results of their study "do not support the hypothesis that SSRI treatment places patients at greater risk of suicide."
SOURCE: American Journal of Psychiatry, July 2007.
