percent lower among those taking any antidepressants than among those not taking antidepressants. However, the association varied by antidepressantindividuals taking an SSRI known as fluoxetine had a 48 percent lower risk of suicide (6.7 deaths per 1,000 total years that individuals took the drug) compared with those not taking medication (11 deaths per 1,000 years), while those taking venlafaxine hydrochloride, another SSRI, had a 61 percent increased risk (22.5 suicide deaths per 1,000 total years of medication use). The risk of death from any cause was 31 percent to 41 percent lower among those taking antidepressants. Those taking SSRIs had a 61 percent reduced risk of death compared with those taking no antidepressants, a fact that could be attributed to a reduction in deaths related to cardiovascular disease and stroke.

Patients taking any kind of antidepressant had a 36 percent increased risk of a subsequent suicide attempt leading to hospitalization (204.7 per 1,000 total years of taking medications) compared with those taking no antidepressants (106.2 per 1,000 years); a slightly greater increase in risk was observed among those age 10 to 19 years (132.7 per 1,000 years for those taking antidepressants vs. 82.9 for those not taking antidepressants).

Among those who had ever taken antidepressants, current antidepressant use was associated with a 39 percent increase in risk of attempted suicide but a 32 percent decrease in risk of completed suicide and a 49 percent reduced risk of death from any cause. "This opposite type of effect on fatal vs. nonfatal suicidal behavior may be explained by an increased risk of intoxication because of easy availability of means (antidepressant medication), resulting in an increase in nonfatal suicidal behavior, and by a decrease in the incidence of violent and more fatal methods of suicide attempts, such as hanging and shooting," the authors write.

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Contact: Jari Tiihonen
Jari.Tiihonen@niuva.fi
JAMA and Archives Journals
4-Dec-2006

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