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New study: antidepressants significantly raise the risk of suicide in the treatment of depression for adults

CyberPanda

Banned
Adults who start treatment with antidepressants for depression are 2.5 times more likely to attempt suicide when compared to placebo, according to new research published today in the journal Psychotherapy and Psychosomatics.

The study found that approximately 1 in every 200 people who start treatment will attempt suicide due to the pharmacologic effects of the drug. This number is significant given around 7.4 million people were prescribed antidepressants in England alone last year, and given international estimates which suggest around 1 in 20 suicide attempts will end in death.

The study, ‘Newer-generation antidepressants and suicide risk in randomized controlled trials: A re-analysis of the FDA database’, reanalyses the safety summaries submitted to the FDA (the US drug regulator) for new generation antidepressants (SSRI, SNRI and atypical serotonergic-noradrenergic antidepressants like mirtazapine). The study was led by Dr Michael P. Hengartner, a senior research fellow at the Zurich University of Applied Sciences and member of the Council for Evidence-based Psychiatry (CEP), and Dr Martin Plöderl, senior researcher at Paracelsus Medical University, Salzburg.

Hengartner and Plöderl examined all suicides and suicide attempts recorded in the safety summaries of all antidepressant trials submitted to the US drug regulator FDA between 1987 and 2013 for marketing authorisation of new antidepressant drugs for the treatment of adult major depression. In these randomised controlled clinical trials, the rate of suicide was about 3 times higher in those taking antidepressants compared to placebo, and the rate of non-fatal suicide attempts and suicides combined was about 2.5 times higher in those taking antidepressant compared to placebo.

Based on this, the study estimates the absolute risk increase in the rate of both fatal and non-fatal suicide attempts for antidepressants vs placebo to be about 0.5%, which is statistically a highly significant effect. While this study does not attempt to identify the precise cause, other studies have suggested that rare adverse drug reactions such as akathisia or extreme agitation, as well as severe withdrawal reactions upon stopping the drug, may increase the suicide risk.

Earlier analysis of this data did not reveal the increased risk because the method used was incorrect. Previously, calculations were based on ‘person exposure years’ (PEY) rather than the number of patients receiving treatment. PEY is not the correct method here (especially when treatment duration with drug and placebo differ) because it assumes that the hazards (i.e. the suicide risk) remain constant over time, whereas the evidence shows that the highest suicide risk occurs in the first four weeks after the start of treatment, as well as shortly after the drug has been stopped. For this reason both the FDA and MHRA require that the number of patients receiving treatment should be used for these calculations rather than PEY.

Other opinion leaders and some patients have argued that antidepressants reduce the overall suicide risk, due to their mood-altering effects. However recent studies across various countries show that, on average, increases in antidepressant prescriptions over time correlate with slightly increased suicide rates. These studies note however that this association does not imply causation.

Commenting on the findings, Dr Hengartner says, ’Our study signals a rare but serious risk that needs to be brought to the attention of healthcare practitioners, particularly when starting or stopping antidepressants. We suggest that this risk should be taken into account when doctors discuss the harms and benefits of SSRI and other newer-generation antidepressants with adult patients. It is also important that people should not stop antidepressants suddenly, and that any reduction should be discussed first with the prescriber. ’

Dr James Davies, co-founder of CEP, says, ‘It is known that antidepressants increase the risk of suicide among young people and adolescents, and for this reason their use is restricted among these patient groups. However this research indicates that suicide risks also occur for some adults. This new evidence should now be reviewed by regulators, reflected in clinical guidelines and brought up in conversations between doctors and their patients.’


The study can be viewed (open access) at the following link: https://www.karger.com/Article/Pdf/501215
 

Hayfield

Banned
I don’t understand why anyone would prescribe drugs for mental wellbeing unless you’re wanting to catatonic them.

Because for some people (like me) they enable us to live a somewhat normal life, they level me out so every emotion isn't on the extreme end of things. I still feel happy, sad, nervous, scared, excited all the emotions everyone else does they are just far more controllable and I can live my life without breakdowns.
 

bitbydeath

Member
Because for some people (like me) they enable us to live a somewhat normal life, they level me out so every emotion isn't on the extreme end of things. I still feel happy, sad, nervous, scared, excited all the emotions everyone else does they are just far more controllable and I can live my life without breakdowns.

It just sounds like delaying the inevitable to me as opposed to tackling the actual problem.
 

bitbydeath

Member
Like with counseling and that sort of therapy? Yep I do that too, the medication is just a part of the treatment. What do you believe is inevitable to happen to me?

It’s a suppressant right? Wouldn’t that make it harder to deal with?

I believe in diet and exercise as that gives natural highs and happiness and also has longer term effects.
 
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Hayfield

Banned
It’s a suppressant right? Wouldn’t that make it harder to deal with?

No, I still feel like the same as everyone else, I still have emotions like everyone else, they allow me to act more rationally especially when it's about myself. Without the tablets I would be a mess and facing the problems as I currently am would not be possible (I know because I tried, after a suicide attempt I decided to take the doctor's advice and medicate as well as therapies). I'm not on the strongest types, there are stronger forms that may hinder someone's emotions so much that they become catatonic but in the UK those are not being prescribed willy nilly.
 
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Tesseract

Banned
i have a hard time believing shit like zoloft is causing deaths, have no doubt the heavier stuff is, the ones that cause brain zaps because your serotonin is completely rebuked
 

Orpheum

Member
It’s a suppressant right? Wouldn’t that make it harder to deal with?

I believe in diet and exercise as that gives natural highs and happiness and also has longer term effects.

Since depression is such a complex illness, linked to so many possible causes, A change of lifestyle does help in some cases but definitely not all. sometimes short medication can help a ton since the emptiness and lack of motivation is gone and hence working out/eating healthy does the job in the long run . I can give the example of my GF who was diagnosed with severe depression, up to the point where she physically was not able to get out of bed and random crying outbursts without any reason, panick/anxiety attacks and so on.... Her future was on the line because she was starting to fail her courses in uni. Anti-depressants did wonders. She was herself again and adapted to a healthy lifestyle in the hopes of this being the long term solution....NOPE did not work, back to medication. There are some side effects but it's nothing to the depression itself so she sticks with it.

Since she goes to med school they were presented with one case of a girl with depression where absolutely nothing helps. No lifestyle change, no medication, nothing. This is completely fucked and one cann only feel for her really.

So yeah i don't disagree with you completely but depression really is a bitch
 

danielberg

Neophyte
It’s a suppressant right? Wouldn’t that make it harder to deal with?

I believe in diet and exercise as that gives natural highs and happiness and also has longer term effects.

Drugs make you feel spaced out/brain foggy this makes you care less about shit so any type of expose therapy is easier to start with and after time you can reduce and get rid of the drugs. Any good professional tells you that in addition to drugs you need therapy and warn against just saying whatever to get the drugs and then bailing on therapy.
The whole diet and exercise thing is a normie perspective/solution it works on normies who feel down for a year or two..doesnt work on people that had mental issues for decades even if you get them to start actually doing it, its a nice positive addition but no solution.
 
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Whitecrow

Banned
That is in all anti-depressant prospects and already well known.

But that is just until it makes the full effect.

Also, it would be greatly appreciated that people doesnt make replies here in the magnitude of 'is better to face and solve your problems than taking medicine'.
When you are depressed, most of time is due to things you cannot control and the situation life put you in. And lots of times you are not even sure what the real problems are.
And even if you are awre of them, it's not like you can solve them magically because your life responsabilities prevent you from that.

Antidepressants are needed.
 
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DunDunDunpachi

Patient MembeR
I can see this be the case for a number of reasons beyond the pills themselves. They play with brain chemistry, after all.

However, they're still necessary. If anything, we overprescribe medicines aimed at anxiety (Xanax) instead of addressing underlying causes of depression (which are often psychological and not physiological) and only using the appropriate medicines when necessary.

Treating psychological problems as a "chemical imbalance" has done a world of hurt to the field. I believe there are spiritual and mental facets involved in depression. It isn't merely due to your brain chemistry.
 

#Phonepunk#

Banned
Lot of drugs with suicidal side effects sail thru thanks to the wonderful folks lobbying for big pharma. When I was a teenager I was on anti acne medicine accutane which made me seriously depressed and even suicidal. It’s still on the market apparently but it’s ok because that is listed as one of the safety warnings. Just slap a “Drug May lead to suicide” warning label and your golden.

Mental health drugs are even weirder. I think they can work but also that it’s a huge shot in the dark. They don’t really know how this stuff effects individual brain chemistry, which is why a lot of trial and error is involved. One of my friend’s dads is a psychiatrist and I flipped through some of his old textbooks, this is common knowledge. They just try different drugs til one work. Kind of insane way to do things tbh
 
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DunDunDunpachi

Patient MembeR
Lot of drugs with suicidal side effects sail thru thanks to the wonderful folks lobbying for big pharma. When I was a teenager I was on anti acne medicine accutane which made me seriously depressed and even suicidal. It’s still on the market apparently but it’s ok because that is listed as one of the safety warnings. Just slap a “Drug May lead to suicide” warning label and your golden.

Mental health drugs are even weirder. I think they can work but also that it’s a hue shot in the dark. They don’t really know how this stuff effects individual brain chemistry, which is why a lot of trial and error is involved.
Wow, recipe for disaster. That sounds like it sucks.

"Here's a medicine that might help alleviate a common but embarrassing teenager problem that you're probably already a bit depressed about. It also makes you more depressed..."
 

Pagusas

Elden Member
It’s a suppressant right? Wouldn’t that make it harder to deal with?

I believe in diet and exercise as that gives natural highs and happiness and also has longer term effects.

Before you continue realize mental illness can be far beyond diet, and different drugs do different things. You seem to be speaking from a place of limited knowledge about them.
Lot of drugs with suicidal side effects sail thru thanks to the wonderful folks lobbying for big pharma. When I was a teenager I was on anti acne medicine accutane which made me seriously depressed and even suicidal. It’s still on the market apparently but it’s ok because that is listed as one of the safety warnings. Just slap a “Drug May lead to suicide” warning label and your golden.

Mental health drugs are even weirder. I think they can work but also that it’s a huge shot in the dark. They don’t really know how this stuff effects individual brain chemistry, which is why a lot of trial and error is involved. One of my friend’s dads is a psychiatrist and I flipped through some of his old textbooks, this is common knowledge. They just try different drugs til one work. Kind of insane way to do things tbh

Accutane literally changed my life and helped me be the first person in my family to not sure insane acne problems into adulthood. The drug did not “sail” through, in fact even now it’s a very hard drug to get prescribed by legit doctors and comes with tons of warnings, checkup requirements and blood draws/lab testing on a consistent schedule. The drug absolutely should be on the market though as it’s a life changer for many people.

You think because you had a bad experience on it, it shouldn’t be on the market?
 
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I'm a minimalist in terms of any type of medicinal/medical intervention, but I'm sure there are those who genuinely benefit in some cases from pharmaceuticals for their mental issues. Whether or not they could receive the same or better results from another avenue of treatment is another debate.

In the end, humans are just trying to cope with our challenges and problems as best we can. It's a messy world out there. Best make your peace.
 

Pagusas

Elden Member
you think because had a good experience that negates potential suicide?

Yes I think some drugs can be life changing and come with risk, and I’d rather have the choice to be on it, than have it not exist at all.

Many drugs that have saved people’s lives can have a potential side effect of littteral death, you think because that is a possibility the drugs shouldn’t be available?
 

lock2k

Banned
It’s a suppressant right? Wouldn’t that make it harder to deal with?

I believe in diet and exercise as that gives natural highs and happiness and also has longer term effects.

It's not that simple. I'll use myself as an example. I exercise, I eat healthy, I'm still a depressed person.

I hate having to resort to medicine, but I have a chemical imbalance that wrecks me when I'm off of it. It comes like a tidal wave, it has no explanation. This whole situation with Etika and what happened to Chester Bennington and Chris Cornell fucking wrecked me because it hits close to home. You have people who are loved, who have money, they have things, they should be fulfilled, but something makes them depressed, and not all the times you know what it is. I always had a good life, I was raised by loving parents, yet, I'm still a depressed person. My mom was as well, and I never really knew why, she just was.

So... it's not that simple, not something you "tackle" like a dirty house that you can clean. You have to do it every day, you gotta have baby steps, and never give up.

I still looking forward to quit my prescription meds someday, but I still haven't managed to do it.

And, in regards to the study, I agree. Some meds made me suicidal for a while. Some of them turn you into a robot. The one I have now makes me function normally but there was one, which was an amphetamine, it made me feel like superman in the first weeks and then it made me feel like I was the most miserable person in the planet... so I talked to my doctor, I went through abstinence and I quit it... I don't know what would have happened if I continued using it.
 
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iconmaster

Banned
Here's another study about antidepressants actually promoting chronic depression in patents:

It feels like the psychiatric field is starting to turn against this line of treatment, though I'm sure big pharma will resist as long as it can.

I can't propose a full ban on them; they've helped me tremendously for over a decade. But maybe it's time to hit the brakes a bit.
 

logicslayer

Member
Duh. That's made clear when advertisements for the drugs are played. Also, your doctor should be informing you of this before putting you on medication. All I know is that my Wife likely wouldn't be here today without the meds.
 

bronk

Banned
Lot of drugs with suicidal side effects sail thru thanks to the wonderful folks lobbying for big pharma. When I was a teenager I was on anti acne medicine accutane which made me seriously depressed and even suicidal. It’s still on the market apparently but it’s ok because that is listed as one of the safety warnings. Just slap a “Drug May lead to suicide” warning label and your golden.

Mental health drugs are even weirder. I think they can work but also that it’s a huge shot in the dark. They don’t really know how this stuff effects individual brain chemistry, which is why a lot of trial and error is involved. One of my friend’s dads is a psychiatrist and I flipped through some of his old textbooks, this is common knowledge. They just try different drugs til one work. Kind of insane way to do things tbh
Shit me too. I called it Accurage. I was fucking insane. How they give it to kids is beyond me. I was insanely reckless and it messed with me big time. Cleared my acne though lol. Side effects were horrendous. I dont think I sweat right nowadays because of it.
 

iconmaster

Banned
One of my friend’s dads is a psychiatrist and I flipped through some of his old textbooks, this is common knowledge. They just try different drugs til one work. Kind of insane way to do things tbh

It's not just common knowledge within the field; psychiatrists IME will flat out tell you this is the case. The meds aren't understood and the course of treatment is a matter of educated guessing. (To be fair, the guys I've seen are pretty good at the educated guessing.)
 
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mekes

Member
Still many breakthroughs to be made with understanding how to combat low mental health. In the UK, doctors just seem to take the basic route of upping serotonin levels. It’s a bit of a crapshoot really, helps a small percentage of people at best.

I had a rough time around 2000 and was given a serotonin booster. I felt awful on it, only time in my life that I have ever felt suicidal. I could feel the change that those particular meds had made to my average day and threw them away in disgust. About a year later that particular drug was all over the news and became known as the ‘suicide drug.’ So, still many breakthroughs to come. And I’m sure they will. So many people suffer with poor mental health that you’d have to think it’s a major focus in terms of treatments,
 
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