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Related Experiment Videos

Suicidality and fluoxetine: is there a relationship?

M Fava1, J F Rosenbaum

  • 1Clinical Psychopharmacology Unit, Massachusetts General Hospital, Harvard Medical School, Boston 02114.

The Journal of Clinical Psychiatry
|March 1, 1991
PubMed
Summary

Antidepressant treatment in depressed patients may increase suicidal ideation. While fluoxetine showed a similar incidence of new suicidal thoughts compared to other antidepressants, the severity was less than previously reported.

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Area of Science:

  • Psychiatry
  • Clinical Pharmacology

Background:

  • A previous report highlighted six depressed patients developing intense suicidal ideation after fluoxetine treatment.
  • This prompted an investigation into antidepressant-induced suicidal ideation in a larger patient cohort.

Purpose of the Study:

  • To survey psychiatrists regarding the incidence of new-onset suicidal ideation in depressed outpatients treated with various antidepressants.
  • To compare the incidence of suicidal ideation associated with fluoxetine versus other antidepressant treatments.

Main Methods:

  • A survey of 27 psychiatrists who treated 1017 depressed outpatients with antidepressants in 1989.
  • Data collected on patients who developed suicidal ideation only after antidepressant treatment initiation.

Main Results:

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  • 3.5% of patients on fluoxetine alone and 6.5% on fluoxetine with tricyclics reported new suicidal ideation.
  • 1.3% on tricyclics (with or without lithium) and 3.0% on other antidepressants also reported new suicidal ideation.
  • The incidence of new suicidal ideation was not significantly different between fluoxetine and other antidepressant groups, and the severity was less than previously reported.

Conclusions:

  • Antidepressant treatment initiation is associated with new-onset suicidal ideation in a subset of depressed patients.
  • Fluoxetine did not show a significantly higher incidence of new suicidal ideation compared to other antidepressants in this study.
  • The severity of suicidal ideation reported in this survey was generally lower than in a prior case report.