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Do Antidepressants Trigger Suicide?

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Over the past 30 years, there have been many isolated reports that certain anti depressants may induce suicidal thoughts and self-destructive behaviors. Almost all manufacturers who make anti depressants even add warnings to the packages about worsening of depression and triggering of suicides. The question that has always been difficult to answer is whether antidepressants actually induce suicidal thoughts or these thoughts are just a part of undertreated depression.

One recent large study from Europe suggests that antidepressants infrequently trigger suicidal thoughts or destructive behaviors. This large study undertaken by Dr. Susanne Stubner of Ludwig-Maximilian University in Munich, Germany. The researchers analyzed medical reports from a drug surveillance program covering more than 300,000 patients treated in psychiatric hospitals in several European countries including Germany, Austria and Switzerland between 1993 and 2008. The drug surveillance data included 142,090 adult patients, who were regularly taking at least one antidepressant, most commonly mirtazapine or venlafaxine.

The researchers only discovered 33 patients who had thoughts of wanting to commit suicide that doctors thought were "possibly" or "probably" related to the antidepressant medication. Eighteen of these patients attempted suicide and three more completed suicides. More than 50 percent of these patients were taking selective serotonin reuptake inhibitors (SSRIs), and 45 percent were also taking some type of benzodiazepine. In the entire study group of patients on antidepressants, 37 percent were taking SSRIs and 32 percent were on benzodiazepines in addition to antidepressants.

Stubner and her colleagues did acknowledge that their study may have missed on some individuals with drug-related suicidal thoughts or acts since the study only relied on drug surveillance reports and not direct interviews with patients. Based on this, the authors concluded that anti depressants rarely trigger suicidality.

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