Antidepressant Use Tied to Suicide Attempts

Article excerpt

PARIS -- A cohort study of 15,390 suicide-prone people in Finland found those who used antidepressants were much more likely to attempt suicide, but also much less likely to complete suicide or to die of any cause.

The use of antidepressants was associated with a 39% increase in suicide attempts, a 32% reduction in completed suicides, and a 49% drop in mortality, Dr. Jari Tiihonen reported at the annual congress of the European College of Neuropsy-chopharmacology.

Dr. Tiihonen, professor and chair of the department of forensic psychiatry at the University of Kuopio in Finland, said the results for patients aged 10-19 corresponded to those for the total study population with one exception. Adolescents were more than five times more likely to die while on paroxetine (relative risk 5.44).

By phrasing the central question addressed by the study as, "Is antidepressant use associated with increased risk of suicidal behavior?" he said in conclusion that the answer is, "Yes, because of the increased risk of attempted suicide ... but at the same time, no, because there is a decreased risk of completed suicide, and this is also very large."

Dr. Tiihonen and his colleagues took advantage of Finland's nationwide computerized database of medical records to conduct the study. The investigators collected data on 15,390 people in a national hospital register who had been hospitalized during 1997-2003 because of suicide attempts. They also gathered data on these patients from a national prescription register and a national mortality register. The average follow-up period was 3.4 years.

"Since prior suicide attempts are the most important risk factor for suicide, a large cohort of suicidal patients would be an obvious choice to investigate the association between antidepressant treatment and the risk of suicide," Dr. Tiihonen said.

The study recorded 602 suicides, 7,136 suicide attempts, and 1,583 deaths in the cohort. "The more prior suicide attempts, the more the risk of suicide goes up as well as the attempts," Dr. …