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Suicide and antidepressants: what current evidence indicates.
Anil Nischal1, Adarsh Tripathi, Anuradha Nischal
1Department of Psychiatry, C.S.M. Medical University, Lucknow, U.P. - 226 003, India.
Mens Sana Monographs
|June 2, 2012
Summary
Antidepressants are generally effective for severe depression and anxiety, including suicidality. While Selective Serotonin Reuptake Inhibitors (SSRIs) may slightly increase suicidal ideation risk in young people, this can be managed with close monitoring.
Area of Science:
- Psychiatry
- Clinical Pharmacology
- Epidemiology
Background:
- Antidepressants are widely used for recurrent severe anxiety and depressive disorders, with assumed benefits for all symptoms, including suicidality.
- Selective Serotonin Reuptake Inhibitors (SSRIs) are a common class of antidepressants.
- Some evidence suggests SSRIs might exacerbate suicidal ideation in vulnerable patients.
Purpose of the Study:
- To systematically review the evidence on the association between Selective Serotonin Reuptake Inhibitors (SSRIs) and suicidality.
- To clarify the risk of suicidality associated with SSRI use across different age groups.
Main Methods:
- Systematic reviews and pooled analyses of experimental, observational, and epidemiological studies were conducted.
- Studies investigating the use of SSRIs and their association with suicidality were included.
- Methodological limitations of the included studies were considered.
Main Results:
- Current evidence does not establish a clear relationship between SSRI use and suicidality risk in adults.
- A slight increase in the risk of suicidal ideation and attempts, but not completed suicides, was observed in children and adolescents.
- The identified risk in younger populations is manageable through clinical vigilance.
Conclusions:
- SSRIs remain a valuable treatment option for severe depression and anxiety across all age groups.
- Clinicians should maintain close follow-up and vigilance for suicidal ideation during initial SSRI treatment, especially in younger patients.
- The potential for increased risk in adolescents should not prevent the use of effective antidepressant dosages when clinically indicated.
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