Further insight into SSRIs and suicide risk published
Suicide risk associated with use of selective serotonin reuptake inhibitors (SSRIs) has been highlighted once more in a series of studies published in the BMJ.
Researchers systematically reviewed randomised controlled trials from
Medline and the Cochrane Collaboration’s register for controlled
trials.
They report more than a two-fold increase in the rate of suicide attempts
in patients receiving SSRIs compared with placebo or therapeutic inter-
ventions other than tricyclic antidepressants. “Although small,
the incremental risk remains an important population health issue because
of the widespread use of SSRIs,” they say.
The researchers also suggest that some major methodological limitations
in the trials analysed may have resulted in the risk of suicide attempts
being underestimated (BMJ 2005;330:396).
In a second study, researchers carried out a meta-analysis of randomised
controlled trials submitted by pharmaceutical companies to the Medicines
and Healthcare products Regulatory Agency. The research shows that neither
a beneficial nor harmful effect of SSRIs on suicide deaths can be ruled
out. However, they did find some evidence of an increased risk of non-fatal
self harm in adults treated with SSRIs (ibid, p385).
A third study revealed no evidence that the risk of suicide was higher
with SSRIs than with tricyclic antidepressants. However, they note that
the trial was not randomised and that preferential prescribing of SSRIs
may have occurred (ibid, p389). |
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