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Suicide risk during antidepressant treatment
Gregory E Simon1, James Savarino, Belinda Operskalski
1Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA. simon.g@ghc.org
The American Journal of Psychiatry
|January 5, 2006
Summary
Antidepressant treatment initiation showed no increased suicide risk with newer drugs. Suicide attempt risk was highest before treatment, declining afterward, especially with newer medications.
Area of Science:
- Psychiatry
- Pharmacovigilance
- Public Health
Background:
- The U.S. Food and Drug Administration (FDA) issued a warning in March 2004 concerning increased suicide risk with newer antidepressant medications.
- Uncertainty exists regarding the actual risk of suicide attempts and deaths during antidepressant treatment.
Purpose of the Study:
- To evaluate the risk of suicide death and serious suicide attempt in relation to the initiation of antidepressant treatment using population-based data.
Main Methods:
- Utilized computerized health plan records for 65,103 patients and 82,285 antidepressant treatment episodes (1992-2003).
- Identified suicide deaths via state and national death certificate data.
- Identified serious suicide attempts (leading to hospitalization) through hospital discharge data.
Main Results:
- In the 6 months post-prescription, 31 suicide deaths and 76 serious suicide attempts were recorded.
- Suicide attempt risk was higher in children/adolescents (314/100,000) than adults (78/100,000).
- Risk of suicide attempt was highest prior to treatment initiation and decreased afterward; no increased risk was observed with newer antidepressants compared to older ones.
Conclusions:
- The risk of suicide during acute antidepressant treatment is approximately 1 in 3,000 episodes.
- The risk of serious suicide attempt is approximately 1 in 1,000 episodes.
- Data do not indicate a significant increase in suicide risk with newer antidepressant drugs.