Antidepressants associated with increased risk for suicide attempts, decreased risk for death

Suicidal individuals taking antidepressant medications appear to have an increased risk of additional suicide attempts, but a reduced risk of dying from suicide or any other cause, according to a large Finnish study reported in the December issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

Major depression is one of the most important risk factors for suicidal behavior, according to background information in the article. However, medications used to treat depression have also been linked to suicidal attempts and behavior, especially among children and adolescents taking a type of antidepressant known as selective serotonin reuptake inhibitors (SSRIs). The issue is difficult to study because the number of completed suicides is relatively low; an effective study would have to include tens of thousands of patients and last for several years. "Because previous suicide attempts are the most important risk factor for predicting suicide, a large cohort of suicidal patients would be an obvious choice to investigate the association between antidepressant treatment and the risk of suicide," the authors write.

Jari Tiihonen, M.D., Ph.D., University of Kuopio and Niuvanniemi Hospital, Kuopio, Finland, and colleagues analyzed data from all individuals hospitalized in Finland for suicide attempts between 1997 and 2003. Information about 15,390 hospitalized individualsincluding age, sex, location, dates of admission and discharge, number of previous hospitalizations for attempted suicide and antidepressant prescriptionswas gathered through Finnish national registries and databases. The patients were followed for an average of 3.4 years to see if they attempted suicide again, completed suicide or died from another cause.

Among the 7,466 males and 7,924 females in the study, 602 suicides, 7,136 suicide attempts leading to hospitalization and 1,583 deaths were recorded during follow-up. The risk of completed suicide was 9

Contact: Jari Tiihonen
JAMA and Archives Journals

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