Title: Re: [NewPacifica] Antidepressants Found Unrelated to Suicide Risk
He might have been bipolar. I like the answer you gave Melinda about the developing brain. I'm not sure but that even strong antihistamine use affects adolescents, but I have no data on that.
Avis
oon 1/5/06 4:10 PM, Pamela Somers at psomers@xxxxxxxxxx wrote:
Avis Worthington wrote:
You say you don't know why he was given the drug? And then give us an
anecdote to dispute wide-spread studies?
No I don't. My friend never made that clear, or if she did I've forgotten, but what stands out in my mind is the fact of her saying what a dynamic "up" individual he was, and how close she was to him, and how totally surprised the family was when he did this, as there had been no indication of depression or suicidal tendencies. As I try to recall, I think he might have been taking something to help him relax, or sleep better. Something like that.
May as well believe in intelligent
design.
I do.
But I have heard more criticism of Zoloft than other drugs.
Avis
Really?
Pam
on 1/4/06 2:35 PM, Pamela Somers at psomers@xxxxxxxxxx wrote:
My personal experience, athough anecdotal, tells me the opposite is
true. The father of a friend, who had always been an upbeat, energetic
man, a doctor who was deeply involved in community organizations and had
many friends, was given an SSRI for some purpose (I don't know the
details of that) and then killed himself leaving no note and no
indication why, to the bewildered and devastated wife and daughters he
left behind. Another friend had a healthy, normal son of about 15 who
was diagnosed with OCD and placed on Zoloft, then ended up trying to
hang himself several times from a bedpost.
Melinda Smith wrote:
http://www.medpagetoday.com/ProductAlert/Prescriptions/tb/2414
Antidepressants Found Unrelated to Suicide Risk
By Jeff Minerd, MedPage Today Staff Writer
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University
of Pennsylvania School of Medicine.
January 03, 2006
MedPage Today Action Points
Explain to patients that the purported association between
antidepressants and increased suicide risk is a matter of ongoing
scientific debate.
Inform patients that the current study found risk of suicide was
decreased, not increased, with antidepressant use.
Review
SEATTLE, Jan. 3 - Despite government-mandated warnings,
antidepressants are not associated with an increase in the risk of
suicide, according to a large population-based study.
The study of more than 65,000 children and adults treated for
depression over a 10-year period starting in 1992 found that suicide
risk declines, not rises, once a patient begins taking
antidepressants, said Gregory E. Simon, M.D., M.P.H., a psychiatrist
with the Group Health Cooperative, a non-profit health care
organization here.
The observational study of patients enrolled in the Group Health
Cooperative concluded that suicide risk is highest in the month before
patients start medication, falls by more than one-half in the month
after starting medication, and declines progressively after that,
according to results published in the January issue of the American
Journal of Psychiatry.
The journal is published by the American Psychiatric Association,
which has been critical of FDA warnings about possible increased risk
of suicide in children and adolescents brought on by treatment with
newer antidepressants.
The FDA continues to stand by its warnings but will include the study
in its comprehensive review of safety data of antidepressants in
adults, said Paul Seligman, M.D., director of the FDA office
responsible for post-marketing drug surveillance.
The FDA warnings, issued in October of 2004, were based on analysis of
24 pediatric trials of various antidepressants involving more than
4,400 patients. The analysis showed a greater risk of suicidal
thinking and behavior during the first few months of treatment in
those receiving antidepressants (4%) compared with placebo (2%). No
actual suicides occurred.
A key difference between the FDA analysis and the current study is
that the FDA analysis did not compare the risk of suicide before
treatment to the risk following treatment and so may have missed the
bigger picture, Dr. Simon and colleagues said. The current study
looked at suicide risk from three months before treatment through six
months after treatment.
In the month before patients went on medication, when suicide risk was
highest, the rate of suicide attempts was nearly 100 per 100,000
treatment episodes, the authors said. This fell to fewer than 50
attempts per 100,000 during the first month of treatment and continued
to decline in subsequent months. This pattern likely reflects
depressive symptoms reaching a critical point that prompted therapy
and improving thereafter,
Among patients treated with newer antidepressants, suicide risk during
the first month of treatment was not significantly higher than during
the subsequent five months (odds ratio=1.6; 95% confidence
interval=0.9-3.1).
Among those treated with older drugs, risk was significantly higher
during the first month of treatment compared with the subsequent five
months (OR=3.6, 95% CI=1.8-6.9), most likely because these drugs
simply take longer to work and not because they increase suicide risk,
the study authors said.
Since the FDA warnings were announced, the APA has expressed concern
that they might cause patients to forgo much-needed treatment with
antidepressants because of exaggerated fears about suicide risk. In
September, the association said that prescribing rates for
antidepressants have declined by 20% for patients 18 and younger since
the warnings were issued.
The current study "challenges the FDA warning that suicidal behavior
may emerge after treatment is begun with antidepressant medications,"
an APA statement said.
The FDA's Dr. Seligman said the new study "reaffirms that the risks
are generally small" and gives a more complete picture than a clinical
trial, because suicidal patients are often excluded from clinical
trials.
However, pending its comprehensive review of clinical trial safety
data in adults, which will take at least a year, the FDA still urges
physicians to carefully monitor patients being treated with
antidepressants for worsening of symptoms or increased suicidal
thinking and behavior, Dr. Seligman said.
Dr. Simon agreed with the FDA's recommendation that doctors carefully
monitor patients taking antidepressants. "Keeping a close watch on
patients after they begin taking these drugs is a good idea-although
not because these medicines are especially risky or dangerous," he
said.
"Patients need to be monitored to ensure they're getting the right
medication in the amount that can help them feel better," he advised.
"There may be subgroups of people who become more agitated or suicidal
after taking these drugs, and those people should seek help from a
doctor or therapist right away if that happens," Dr. Simon said. "But
our study showed that on average, the risk of suicide actually goes
down after people start taking the antidepressant."
Primary source: American Journal of Psychiatry
Source reference:
Simon GE et al. Suicide risk during antidepressant treatment. American
Journal of Psychiatry. 2006; 163:1-7.
--
Melinda Smith =^..^=
http://angelfire.com/zine/melsbasketcase
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