Is there evidence for negative effects of antidepressants on suicidality in depressive patients?

@article{Mller2006IsTE,
  title={Is there evidence for negative effects of antidepressants on suicidality in depressive patients?},
  author={H. M{\"o}ller},
  journal={European Archives of Psychiatry and Clinical Neuroscience},
  year={2006},
  volume={256},
  pages={476-496}
}
  • H. Möller
  • Published 2006
  • Medicine
  • European Archives of Psychiatry and Clinical Neuroscience
The role of antidepressants in suicide prevention is a major public health question given the high prevalence of both depression and depression-related suicidality. Therefore all available means should be utilised to clarify the influence of antidepressants on suicidality, especially in view of the ongoing intensive debate about possible suicidality-inducing effects of antidepressants that may outweigh their traditionally hypothesised beneficial effects. This paper gives a systematic and… Expand
Evidence for beneficial effects of antidepressants on suicidality in depressive patients
  • H. Möller
  • Medicine
  • European Archives of Psychiatry and Clinical Neuroscience
  • 2006
TLDR
There seems to be reasonable evidence from different research approaches that antidepressants are able to reduce suicidal Ideation and also suicidal behaviour in depressive patients, and the evidence for the beneficial effect on suicidal ideation comes from randomised control group studies. Expand
Do SSRIs or antidepressants in general increase suicidality?
TLDR
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The controversial link between antidepressants and suicidality risks in adults: data from a naturalistic study on a large sample of in-patients with a major depressive episode.
TLDR
In-patient treatment in a psychiatric care setting, including daily assessments of suicidality by trained psychiatrists adhering to the rules of good clinical practice (e.g. use of specific co-medications, supportive psychotherapy and continuous medical attendance by nursing staff) might be beneficial. Expand
Position statement of the European Psychiatric Association (EPA) on the value of antidepressants in the treatment of unipolar depression
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j Abstract In the past few years several papers have reported critically on the risk of suicidal thoughts and behaviour associated with antidepressants, primarily SSRIs. The risk-benefit ratio ofExpand
Problems in determining efficacy and effectiveness of antidepressants.
TLDR
It is clear that when concepts of evidence-based medicine and health economy are applied, which are far away from clinical thinking, problems occur and results are very difficult to interpret in clinical terms. Expand
Antidepressant-induced suicidality: implications for clinical practice.
TLDR
Investigations of antidepressant-induced suicidality in adults and the clinical implications of research findings and FDA warnings for clinicians treating adults with depression are discussed. Expand
Switching, Induction of Rapid Cycling, and Increased Suicidality With Antidepressants in Bipolar Patients: Fact or Overinterpretation?
TLDR
It appears that, at least, the switch risk, and perhaps also the risk for rapid cycling and new-onset suicidality have been overinterpreted, and this raises doubt about the efficacy of anti-depressants as a primary-treatment choice in bipolar depression. Expand
Longitudinal analysis of the suicidal behaviour risk in short-term placebo-controlled studies of mirtazapine in major depressive disorder
TLDR
The results based on pooled data from 15 placebo-controlled, short-term studies of mirtazapine in MDD using the suicide item scores from the HAMD as a proxy outcome measure for suicidality risk demonstrate that mirtzapine was associated with statistically significantly lower suicideality risk compared to placebo. Expand
Antidepressant‐Induced Suicidality: An Update
TLDR
An update of the controversy surrounding antidepressants as a potential cause of suicidal ideations or behavior is provided and it appears that antidepressant‐induced suicidality appears to be an uncommon occurrence but also a legitimate phenomenon. Expand
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References

SHOWING 1-10 OF 132 REFERENCES
Evidence for beneficial effects of antidepressants on suicidality in depressive patients
  • H. Möller
  • Medicine
  • European Archives of Psychiatry and Clinical Neuroscience
  • 2006
TLDR
There seems to be reasonable evidence from different research approaches that antidepressants are able to reduce suicidal Ideation and also suicidal behaviour in depressive patients, and the evidence for the beneficial effect on suicidal ideation comes from randomised control group studies. Expand
Antidepressants and suicide: risk-benefit conundrums.
TLDR
The data reviewed here make it difficult to sustain a null hypothesis that SSRIs do not cause problems in some individuals and further studies or further access to data are indicated to establish the magnitude of any risk and the characteristics of patients who may be most at risk. Expand
Antidepressants and suicide: what is the balance of benefit and harm
TLDR
Although antidepressant prescribing in Britain has more than doubled in the past 15 years, population suicide rates have fallen and long term studies are required to assess the risks and benefits to population health of recent large scale rises. Expand
Antidepressants--do they decrease or increase suicidality?
Based on an intensive review of the literature, the question was analyzed as to whether antidepressants have an influence on suicidality and whether there are specific differences between certainExpand
Do antidepressants t(h)reat(en) depressives? Toward a clinically judicious formulation of the antidepressant-suicidality FDA advisory in light of declining national suicide statistics from many countries.
TLDR
The overall evidence suggests that the widespread use of antidepressants in the new "SSRI-era" appear to have actually led to highly significant decline in suicide rates in most countries with traditionally high baseline suicide rates. Expand
Antidepressants use in children and adolescents and the risk of suicide
TLDR
Caution is called for in the use of all SSRIs and NSRIs in the paediatric population in the absence of contradictory information, and caution in theUse of other antidepressants in this population should be exercised as well. Expand
Use of Selective Serotonin Reuptake Inhibitors in Children and Adolescents
TLDR
There is insufficient safety information from the randomised controlled trials to confirm a definite association between SSRIs and suicidality, and analysis of suicide and antidepressant prescribing trends in three countries and a large case-control study do not support the hypothesis that there is a link between use of SSRIS and death caused by suicide. Expand
Antidepressant Drugs and the Emergence of Suicidal Tendencies
TLDR
Data clearly demonstrate that antidepressants ameliorate suicidal ideation more effectively than placebo in patients with depression, and observations suggest that antidepressants may redistribute suicide risk, attenuating risk in some patients who respond well, while possibly enhancing risk in others who respond more poorly. Expand
Suicide attempts in clinical trials with paroxetine randomised against placebo
TLDR
The probability of increased intensity of suicide attempts per year in adults taking paroxetine was 0.90 with a "pessimistic" prior, and somewhat less with two more neutral priors, which support the results of recent meta-analyses. Expand
[Selective serotonin reuptake inhibitors in major depressive disorder in children and adolescents (ratio of benefits/risks)].
TLDR
The analyse of 48 277 depressed patients participating in RCT for nine FDA approved antidepressants fail to support an overall difference in suicide risk between antidepressants (SSRI) and placebo treated subjects, and the link between "suicidality" and MDD can not be excluded. Expand
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