Selective serotonin reuptake inhibitors and suicidal behaviour: a population-based cohort study

Area of Science:

• Psychiatry
• Pharmacology
• Public Health

Background:

• Selective serotonin reuptake inhibitors (SSRIs) are widely prescribed for depression and anxiety.
• Concerns exist regarding a potential link between SSRI treatment and increased suicidal behavior, especially in younger populations.
• Existing research on this relationship remains debated.

Purpose of the Study:

• To investigate the association between SSRI treatment initiation and the risk of suicidal behavior.
• To examine whether this association differs between age groups or individuals with a history of suicidal attempts.

Main Methods:

• Utilized nationwide Swedish registers to identify individuals aged 6-59 years who initiated SSRI treatment between 2006 and 2013.
• Employed a within-individual design to compare suicidal behavior risk in periods before and after SSRI treatment initiation.
• Estimated incidence rate ratios (IRRs) for suicidal behavior.

Main Results:

• The 30 days preceding SSRI initiation showed the highest risk of suicidal behavior.
• SSRI treatment periods were associated with a reduced risk of suicidal behavior compared to the period immediately before initiation (IRR=0.62).
• Risk reduction increased over the course of treatment and was consistent across age groups and history of attempts.

Conclusions:

• SSRI treatment does not appear to increase the risk of suicidal behavior in youths or adults.
• Findings suggest that SSRI treatment may, in fact, reduce the risk of suicidal behavior.
• Further research using diverse methodologies and populations is recommended.