Increase in Suicidal Thoughts and Tendencies

Ryan, Hewitt F.; Merrill, F. Bruce; Scott, George E.; Krebs, Richard L.; Thompson, Betty L.

doi:10.1001/jama.1968.03140130049015

Cited by 49 publications

(6 citation statements)

References 2 publications

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“…The early appearance of depression was also noted in Willunson's study (1985) with diazepam, but not in a similar investigation by Gundlach and colleagues (1 966). When depression occurs, lowering the dosage has been reported to be helpful (Ryan et al, 1968;Smith and Salzman, 1991), but in our study drug reduction was not successful in the one lorazepam-treated patient in whom it was tried. A problem in clinical trials, including our own experience, is the lackofprecise definition of the term depression, and it is not known how many patients with benzodiazepine-emergent depression would have satisfied DSM-III-R criteria for major depression.…”

Section: Discussioncontrasting

confidence: 75%

“…Depression is often listed in reference texts as a side effect associated with benzodiazepine treatment (Gilman etal., 1985;Gelenbergetal., 1991;PDR, 1992). Clinical trials and case reports have described depression, sometimes accompanied by suicidal ideation, which emerged as part of diazepam treatment (Ryan et al, 1968;Hall and Joffee, 1972;Rao, 1967;Gundlachetal., 1966;McDowall et al, 1966), and other clinical trials have noted depression in association with lorazepam (Lydiard et al, 1989;Fontaine et al, 1986), alprazolam (Lydiard et al, 1987), and clonazepam (Pollack et al, 1986) in patients treated for anxiety, obsessive-compulsive, and panic disorders. In a 4-week trial comparing lorazepam, bromazepam, 0 1993 WILEY-LISS, INC. and placebo in 60 patients with generalized anxiety disorder (GAD), lorazepam-treated patients tended to have more emergent depression (7/20 or 3 5 %) than those treated with the benzodiazepine bromazepam (4/20 or 20%) or placebo (2/20 or lo%), with depression severe enough to cause suicidal ideation in one patient on each active drug (Fontaine et al, 1986).…”

Section: Introductionmentioning

confidence: 99%

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Depression in the course of treatment of generalized anxiety disorder with lorazepam, ipsapirone, and placebo: Results from a multicenter trial

et al. 1993

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The present report addresses the occurrence of depression during a multicenter, double‐blind, randomized, placebo‐controlled trial investigating the comparative anxiolytic efficacy of ipsapirone and lorazepam versus placebo in generalized anxiety disorder (GAD). Patients who entered the study scored ≥18 on the HAM‐A, scored ≥ 8 on the Covi anxiety scale, and scored ⩽ 7 on the Raskin depression scale. Patients were randomized to lorazepam (2–6 mg/day), ipsapirone (10–30 mg), or placebotid for 4 weeks acute treatment. Efficacy of ipsapirone versus lorazepam and placebo in GAD was assessed with weekly HAM‐A and CGI ratings. Worsening or emergence of depression was assessed with HAM‐D ratings performed at baseline and weeks 2 and 4. Adverse events were assessed weekly. Ninety‐six males and 161 females (age range 18–78 years) were valid for efficacy after a 4‐week acute treatment period. HAM‐A and CGI scores were significantly reduced with lorazepam and ipsapirone compared with placebo. HAM‐D scores were also reduced significantly from baseline in the lorazepam, ipsapirone, and placebo groups; HAM‐D core items significantly decreased in the ipsapirone but not in the lorazepam and placebo groups. Individual incidents of depression showed significantly (p < 0.05) higher frequency in the lorazepam group (10/104; 9.6%) compared with ipsapirone (2/106; 1.9%), but only a trend (p < 0.10) compared with placebo (4/105; 3.8%). There was an increased severity of the depressive incidents in the lorazepam group compared with the other two treatment groups. This report confirms an earlier study reporting that depression is a potential side effect of lorazepam treatment in GAD patients. Depression 1:172–176 (1993). © 1993 Wiley‐Liss, Inc.

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Section: Discussioncontrasting

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Depression in the course of treatment of generalized anxiety disorder with lorazepam, ipsapirone, and placebo: Results from a multicenter trial

et al. 1993

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“…(1) tension-anxiety, (2) angerhostility, (3) confusion, (4) depression-dejection, (5) vigor, (6) fatigue, (7) friendliness, and (8) total mood disturbance.…”

Section: Methodsmentioning

confidence: 99%

Differential Effects of Diazepam and Pentobarbital on Mood and Behavior

Griffiths¹,

Bigelow²,

Liebson

1983

Arch Gen Psychiatry

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“…Finally, the findings on aggressionl autoaggression under treatment with benzodiazepines seem to be of interest. Ryan et al (1968) found an association between the commencement of diazepam therapy and the onset of suicidal thoughts and tendencies in seven patients. Hall and Joffe (1972) reported on six patients taking diazepam at more than the maximum recommended dose.…”

Section: Paroxetine: Placebomentioning

confidence: 93%

Antidepressants - Do they Decrease or Increase Suicidality?

Möller¹

1992

Pharmacopsychiatry

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Based on an intensive review of the literature, the question was analyzed as to whether antidepressants have an influence on suicidality and whether there are specific differences between certain subgroups of antidepressants. In general, antidepressants reduce suicidal ideations in depressive patients. A faster onset of this kind of action in serotonin-reuptake inhibitors is not yet completely proved. The hypothesis, described by clinicians, of a specific suicidality-increasing risk being associated with a certain group of antidepressants (e.g., antidepressants with a drive-enhancing, non-sedating clinical profile, drugs with a certain biochemical mode of action) has hitherto not been confirmed in control-group studies. An unspecific induction of suicidality, observable also under other psychoactive drugs, appears to be quite rare and occurs only under predisposing conditions, such as personality disorders and comedication with other drugs.

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Increase in Suicidal Thoughts and Tendencies

Cited by 49 publications

References 2 publications

Depression in the course of treatment of generalized anxiety disorder with lorazepam, ipsapirone, and placebo: Results from a multicenter trial

Depression in the course of treatment of generalized anxiety disorder with lorazepam, ipsapirone, and placebo: Results from a multicenter trial

Differential Effects of Diazepam and Pentobarbital on Mood and Behavior

Antidepressants - Do they Decrease or Increase Suicidality?

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