Study Probes Suicide, Antidepressants
Antidepressants Up Suicide Attempts -- But Cut Actual Suicides
Dec. 4, 2006 -- Antidepressant treatment ups a person's risk of suicide attempts -- but cuts the risk of actual suicide, data from Finland reveal.
Also, in a surprising finding, the same study suggests a link between antidepressant use and reduced risk of death overall.
The reason for this apparent benefit is unclear and will require further study, the researchers report.
The Finnish study comes in the midst of continuing controversy over the benefits vs. risks of antidepressants.
Clinical trials of antidepressants find that people who begin treatment seem to have a higher risk of suicidal thoughts and gestures.
That is why the drugs' labels carry a strong warning that they may up a depressed person's risk of suicide.
But the new findings suggest the real culprit is depression, not antidepressant drugs, says Jari Tiihonen, MD, PhD, chairman of the department of forensic psychiatry at the University of Kuopio, Finland.
"We found out the use of antidepressant treatment was associated with increased risk of attempted suicide," Tiihonen tells WebMD.
"But treatment was also associated with decreases in completed suicide," he says.
When people on antidepressants attempt suicide, Tiihonen says, they most often try to kill themselves by taking too many antidepressant pills.
"When patients have antidepressant medications at home, it is easy for them to open the bottle and make a suicide attempt," he says. "Nowadays, these drugs are not so toxic, so it is hard to kill oneself with these medicines."
However, they rarely attempt suicide by more fatal means. "Suicide attempts by hanging and shooting are not increased among patients taking antidepressants," Tiihonen says.
This makes a lot of sense to Robert D. Gibbons, PhD, director of the Center for Health Statistics and professor of psychiatry at the University of Illinois at Chicago.
"If you are taking an antidepressant, it is pretty good evidence that you are depressed," Gibbons says. "Giving depressed patients bottles of pills that can be used to attempt suicide could increase the suicide attempt rate."
Suicide Due to Depression, Not Antidepressants
Tiihonen and colleagues took advantage of the extraordinarily detailed medical records kept on every person living in Finland.