Suicide Attempts Decline After Depression Treatment, Study Finds

[TZ]

ScienceDaily (Jul. 2, 2007) — In a study of more than 100,000 patients treated for depression, suicide attempts declined during the first month of treatment--whether that treatment consisted of medication, psychotherapy, or both. The findings, published by Group Health researchers in the July American Journal of Psychiatry, show a similar pattern for populations of adolescents and young adults (up to age 24) as for older adults.


The study sheds new light on the "black box" advisory that the U.S. Food and Drug Administration (FDA) placed in 2004 and has revised since then, said Greg Simon, MD, MPH, the Group Health psychiatrist who led the study. The advisory--which has concerned many patients, families, and care providers--warns that suicidal behavior may emerge soon after people younger than 25 start treatment with newer antidepressant medications called selective serotonin reuptake inhibitors (SSRIs). It was spurred by randomized placebo-controlled trials showing that starting to take an SSRI can make thoughts of suicide more common among some teens and young adults.

Dr. Simon's study is the first published research to compare the risk of suicide attempts before and after the start of treatment with not only antidepressants but also psychotherapy. It is based on computerized medical and pharmacy records for more than 109,000 patients who started treatment for depression at Group Health from 1996 to 2005
http://www.sciencedaily.com/releases/2007/07/070701094054.htm
I think 100,000 is a large enough group to say definitively this is NOT a placebo effect.

[Win]

1. Here's one

Here's an SSRI. Wonder if they checked this one.

http://www.petitiononline.com/mod_perl/signed.cgi?effexor&1

[TZ]

2. Probably

All SSRI's have some side effects. And they don't work right for each individual.If these people are serious and not just out to get monetary compensation they would go to the FDA. Sounds like some ambulance chaser thought this up I have been on three SSRI's---Prozac, Wellbutrin, and Lexaparo and the worst side effect was a decrease in my libido.
Oh yeah. I wonder how many people followed their doctor's orders on the dosages. Or quit cold turkey. Both are EXTREMELY dangerous.

SSRI's save lives and anyone who refuses to see that doesn't know ANYTHING about mental health

[shireen]

7. totally agree

I read that petition and had the same reaction. For every person who signed that petition against Effexor, several more were helped by it.

[lizerdbits]

3. Um, that's a petition

Are you saying that the petition means the drug is ineffective?

[depakid]

4. Well, several studies have already shown rather conclusively

that there IS a suicide side effect with SSRI's (particularly with teens, where meta analyses have also shown limited to no efficacy when compared with placebos and/or talk therapy).

This is sometimes explained via the "activation effect," whereby the depressed patient suddenly has the energy to act on their dark thoughts. The risk is exacerbated by poor monitoring by providers, who often aren't trained in psychiatry- and where patients aren't concurrently receiving an appropriate talk regimine, such as cognitive behavioral therapy, that deals with those underlyng thoughts, potential trauma, and feelings.

Anti-depressants aren't magic bullets. They need to be prescribed with caution, and not simply handed out like candy (often in the form of free samples) by GP's. They may work well for some, not so well for others, and for still others, they can be a disaster- inducing hypomania or even a full blown manic episode, resulting is a significantly worse long term prognosis.

[bananas]

5. Was this a placebo-controlled study?

[Celebration]

6. LOL, no

Can you imagine a study of 100,000 being placebo controlled? That boggles the mind. This is just studying a database of before and after treatment, using various combinations of treatment modalities and comparing them.

So, any type of treatment made the suicide rate go down. That is good to know. People who are depressed should get treatment. I have a weird feeling that if a placebo pill was one of the thing studied, it would have turned out the same as the other treatments.

The strange thing about the SSRIs in kids is that they haven't been shown to actually increase suicide, just suicidal thoughts. That is bad, but not so bad as acting on the thoughts of course.

I would go for talk therapy, relaxation techniques, biofeedback, cognitive behaviour therapy, etc., before going the SSRI route, especially for kids. There is no telling what they do long term. People get hooked on them. They are difficult to stop, and it is harmful to the fetus for pregnant women to take this drugs, and yes, they do it all the time. It's an anecdote but my daughter has a friend who did that, and the baby, of all things, is in la la land--doesn't care about doing anything but sit around. Sad, sad, sad. No causation proven of course, just a strong suspicion. But they aren't a good thing in pregnancy.