New Research Belies Link Between SSRIs and Suicide in Young Adults

Internal Medicine World Report, August 2007, Volume 0, Issue 0

New Data Show Reduced Risk

By Rebekah McCallister

Contrary to a recent FDA recommendation to extend the black box warning on selective serotonin reuptake inhibitors (SSRIs) to suggest an associated increased risk of suicidal behavior in young adults, a new study has shown that this drug class actually lowers the risk of suicide in adults with depression—a trend that also holds true for young adults aged 18 to 25 years (Am J Psychiatry. 2007; 164:1044-1049).

"The risk of suicide attempt among depressed patients treated with SSRI drugs was about one third that of patients who were not treated with an SSRI," said lead investigator Robert Gibbons, PhD, director of the Center for Health Statistics and professor of biostatistics and psychiatry at the University of Illinois at Chicago. "We would not expect a lower risk in this patient population, because patients treated with SSRIs are generally more severely depressed and would have a higher risk of suicide attempt."

The study included an analysis of medical data from 226,866 patients in the Veterans Administration healthcare system who were first diagnosed with depression in 2003 or 2004.

The risk of suicide in 4 age-groups (18-25, 26-45, 46-65, and >65 years) was compared before and after treatment with an SSRI.

In all age-groups, SSRI therapy significantly lowered the risk of a suicide attempt compared with the control group of patients with depression who did not receive antidepressant therapy. Among 82,828 patients, 183 suicide attempts occurred before SSRI treatment and 102 suicide attempts after SSRI treatment; respective rates were 221 per 100,000 and 123 per 100,000 people.

Dr Gibbons cautions that extending the black box warning to young adults may further decrease the use of effective antidepressant treatment for depression and contribute to increasing rates of suicide.