Risks overstated for antidepressants and suicides

When the U.S. Food and Drug Administration issues a black box warning, it is usually to alert physicians of a serious side effect of a drug. That warning is highlighted in all of the package material of the pharmaceutical and is a big deal. For years, the SSRI antidepressants have carried a black box warning that the drug might cause suicide in children and adults. This warning was there despite the fact that no actual suicides occurred during the drug trials, but patients did experience suicidal thoughts and behavior. I remember hearing about lawsuits against psychiatrists when medication was prescribed and it was thought to have contributed to suicide attempts.

A new meta-analysis study has been published in the Archives of General Psychiatry that analyzed 9,185 patients who took Fluoxetine (Prozac) and Venlafaxine (Effexor). These included 7,517 adults, 960 geriatric patients and 708 youths. Contrary to the black box warning, they found that these medications decreased suicidal thoughts and behavior in adults compared to placebo. No differences were found for youths. In all age groups, severity of depression improved with medication and was significantly related to suicidal thoughts. There were no suicides that were attributed to the medication.

This study is important because some clinicians may not prescribe and some patients may be afraid to take antidepressants that could significantly help their quality of life. Major depressive disorders are life threatening and SSRI medication has been an amazing modern breakthrough to help people get back on track.

If you Google this topic you get lots of scary anecdotal information about antidepressants causing suicide and violence along with the usual conspiracy stories and pharmaceutical bashing. When you consider that 70% of people who commit suicide did not see a psychiatrist within the last year, you realize how serious depression is.

Antidepressants do not cure life problems, but they bring significant relief and save significant lives in millions of humans.

This post originally appeared at Everything Health. Toni Brayer, MD, FACP, is an ACP Internist editorial board member who blogs at EverythingHealth, designed to address the rapid changes in science, medicine, health and healing in the 21st Century.