Relationship Between Antidepressant Medication Treatment and Suicide in Adolescents

Olfson, Mark; Shaffer, David; Marcus, Steven C.; Greenberg, Tsafrir

doi:10.1001/archpsyc.60.9.978

Cited by 368 publications

(183 citation statements)

References 44 publications

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“…The lower bound of this confidence interval suggests that an increase in SSRI sales in Sweden equal to 13 percent over 1999 or 2000 levels (about two defined daily doses per capita) could reduce suicide rates by up to 2.6 percent, consistent with the estimate presented above from our panel of country-level data. The magnitude of our estimate is significantly smaller than what is presented in the study of adolescent suicides by U.S. ZIP code area by Olfson et al (2003), but as noted above we have significant concerns about the key explanatory variable of interest used in their study. els.…”

Section: Discussionmentioning

confidence: 57%

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Anti-depressants, suicide, and drug regulation

Ludwig

Marcotte

2005

J. Pol. Anal. Manage.

131

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Section: Discussionmentioning

confidence: 57%

“…Olfson et al (2003) focus on changes between 1985-89 and 1995-99 in suicide rates to adolescents within three-digit ZIP code regions. They find that suicide rates for children 10-19 decline more in regions that experience a relatively greater increase in the "antidepressant medication treatment rate," defined as the num- , 1950-2000.…”

Section: Introductionmentioning

confidence: 99%

Anti-depressants, suicide, and drug regulation

Ludwig

Marcotte

2005

J. Pol. Anal. Manage.

131

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“…In fact, between 1985 and 1999, the suicide rate in the US decreased from 12.4 to 10.7 per 100,000, while the prescription of AD (predominantly SSRI) was quadrupled 42 . In North American teenagers, for every 1% increase in AD prescription, there was a decrease of 0.23 suicides per 100,000 annually (p < 0.001) 43,44 . Additionally, the 13% increase in SSRI sales in 27 countries during 1999 reduced suicide rates by 2.5% in those countries.…”

Section: Usage Of Antidepressants and Decrease In Suicidal Ratesmentioning

confidence: 97%

Ten years after the FDA black box warning for antidepressant drugs: a critical narrative review

Martínez-Aguayo¹,

Arancibia²,

Concha³

et al. 2016

Arch. Clin. Psychiatry (São Paulo)

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Background: The United States Food and Drug Administration (FDA) has warned about the increased suicidality risk associated with the use of selective serotonin reuptake inhibitors (SSRI) and venlafaxine in children and adolescents. Objectives: To critically appraise the available evidence supporting the FDA Black box warning concerning to the use of antidepressants in child and adolescents. Methods: A critical review of articles in Medline/PubMed and SciELO databases regarding the FDA Black box warning for antidepressants, and the impact of FDA warnings on antidepressant prescriptions and suicide rates. Results: The warning was based on surveys that did not report either cases of suicide nor a significant difference supporting an increased suicidality rate. The concept was defined in an ambiguous way and there is currently more available evidence to support such definition. The use of SSRI and venlafaxine has been associated to lower suicidality rates, but the prescription fall due to the warning increased suicide rates. Discussion: Suicidality is an inherent feature of depressive disorders so it would be desirable to consider how much of the phenomenon may be attributed to antidepressants per se. It would be appropriate to consider that suicide rates might increase also as a consequence of the warning.

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“…Depressive illness is associated with great personal suffering, an increased risk of suicide and most sufferers will experience at least one recurrence during their life time. At a population level several studies have reported an association between increasing antidepressant use and a reduction in suicide rates, though the potential effect of confounders makes it impossible to prove that this is a causal relationship (Henriksson and Isacsson, 2006;Olfson et al, 2003). Antipsychotic drugs have proven efficacy in the acute (Davis et al, 2003) and long-term treatment of schizophrenia (Leucht et al, 2003b) and the treatment of mania (Perlis et al, 2006).…”

Section: Avoiding Adverse Effectsmentioning

confidence: 99%

Neurological complications of psychiatric drugs: clinical features and management

Haddad

Dursun

2007

Hum. Psychopharmacol. Clin. Exp.

190

106

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This paper reviews the main neurological complications of psychiatric drugs, in particular antipsychotics and antidepressants. Extrapyramidal syndromes include acute dystonia, parkinsonism, akathisia, tardive dyskinesia and tardive dystonia. Extrapyramidal symptoms (EPS) are less frequent with atypical than with conventional antipsychotics but remain common in clinical practice partly due to lack of screening by health professionals. Neuroleptic malignant syndrome (NMS) consists of severe muscle rigidity, pyrexia, change in conscious level and autonomic disturbance but partial forms also occur. NMS is particularly associated with the initiation and rapid increase in dose of high-potency antipsychotics but it has been reported with all the atypical antipsychotics and rarely with other drugs including antidepressants. Serotonin toxicity comprises altered mental state (agitation, excitement, confusion), neuromuscular hyperactivity (tremor, clonus, myoclonus, hyperreflexia) and autonomic hyperactivity and occurs on a spectrum. Severe cases, termed serotonin syndrome, usually follow the co-prescription of drugs that increase serotonergic transmission by different pathways, for example a monoamine oxidase inhibitor (MAOI) and a selective serotonin reuptake inhibitor (SSRI). Most antipsychotics and antidepressants lower the seizure threshold and can cause seizures; the risk is greater with clozapine than with other atypical antipsychotics and greater with tricyclic antidepressants (TCAs) than with SSRIs. In randomised controlled trials in elderly patients with dementia atypical antipsychotics are associated with a higher risk of stroke and death than placebo. Cohort studies suggest that conventional drugs carry at least the same risk. Cessation of treatment with antipsychotics and antidepressants can lead to a wide range of discontinuation symptoms which include movement disorders and other neurological symptoms. Clinicians need to be familiar with strategies to reduce the risk of these adverse events and to manage them when they arise. Their occurrence needs to be balanced against the benefits of psychiatric drugs in terms of efficacy and improved quality of life in a range of disorders.

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Relationship Between Antidepressant Medication Treatment and Suicide in Adolescents

Abstract: An inverse relationship between regional change in use of antidepressants and suicide raises the possibility of a role for using antidepressant treatment in youth suicide prevention efforts, especially for males, older adolescents, and adolescents who reside in lower-income regions.

Cited by 368 publications

References 44 publications

Anti-depressants, suicide, and drug regulation

Anti-depressants, suicide, and drug regulation

Ten years after the FDA black box warning for antidepressant drugs: a critical narrative review

Neurological complications of psychiatric drugs: clinical features and management

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