Suicides and Suicide Attempts during Long-Term Treatment with Antidepressants: A Meta-Analysis of 29 Placebo-Controlled Studies Including 6,934 Patients with Major Depressive Disorder

@article{Braun2016SuicidesAS,
  title={Suicides and Suicide Attempts during Long-Term Treatment with Antidepressants: A Meta-Analysis of 29 Placebo-Controlled Studies Including 6,934 Patients with Major Depressive Disorder},
  author={Cora Braun and Tom Bschor and Jeremy Franklin and Christopher Baethge},
  journal={Psychotherapy and Psychosomatics},
  year={2016},
  volume={85},
  pages={171 - 179}
}
Background: It is unclear whether antidepressants can prevent suicides or suicide attempts, particularly during long-term use. Methods: We carried out a comprehensive review of long-term studies of antidepressants (relapse prevention). Sources were obtained from 5 review articles and by searches of MEDLINE, PubMed Central and a hand search of bibliographies. We meta-analyzed placebo-controlled antidepressant RCTs of at least 3 months' duration and calculated suicide and suicide attempt… Expand
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Suicide risk with selective serotonin reuptake inhibitors and new-generation serotonergic-noradrenergic antidepressants in adults: a systematic review and meta-analysis of observational studies
TLDR
Exposure to new-generation antidepressants is associated with increased suicide risk in adult routine-care patients with depression and other conditions and contributes to systematic underestimation of risk estimates in the published literature. Expand
Treatment-resistant depression and suicidality.
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The completed and attempted suicide incidences are high, but these incidences did not differ between three end of the line treatments (DBS, VNS or ECT). Expand
Psychopharmacological treatment is not associated with reduced suicide ideation and reattempts in an observational follow-up study of suicide attempters.
TLDR
Depression scores suggest that patients on psychotropic medication had more psychiatric pathology, which may be a confounding factor for the effect of medication on suicidal behavior. Expand
Suicide risk with selective serotonin reuptake inhibitors and other new-generation antidepressants in adults: a systematic review and meta-analysis of observational studies
TLDR
Exposure to new-generation antidepressants is associated with higher suicide risk in adult routine-care patients with depression and other treatment indications and likely contribute to systematic underestimation of risk in the published literature. Expand
Predictors of re-attempt in a cohort of suicide attempters: A survival analysis.
TLDR
A correct psychopharmacological treatment is insufficient to prevent re-attempts in populations at risk, and strategies to increase compliance should be taken into account as part of prevention programs. Expand
Suicidal Ideation and Suicidal Behavior as Rare Adverse Events of Antidepressant Medication: Current Report from the AMSP Multicenter Drug Safety Surveillance Project
TLDR
The study supports the view that antidepressant drug-triggered suicidal ideation and suicidal behavior (primarily with selective serotonin reuptake inhibitors) are rare and might be preferable to antidepressant drug monotherapy when beginning treatment. Expand
Antidepressants and suicidality: A re-analysis of the re-analysis.
TLDR
It is shown that, in the case of rare events, the data is very sensitive to different analytical approaches underlining the importance of further investigations and the necessity of sensitivity analysis. Expand
Suicide in psychiatric disorders: rates, risk factors, and therapeutics
TLDR
Lithium is underutilized clinically but has substantial evidence of long-term preventive effects on attempts and suicide in bipolar disorder (BD), and possibly also in patients with major depressive disorder (MDD) and some second-generation antipsychotics have evidence of efficacy in depression, particularly acute bipolar depression. Expand
Lithium in the episode and suicide prophylaxis and in augmenting strategies in patients with unipolar depression
TLDR
It is concluded that lithium is an effective prophylactic treatment for carefully selected patients with unipolar depression and is safe when prescribed in recommended doses/plasma lithium levels and with regular, careful monitoring. Expand
Antisuicidal Effects in Mood Disorders: Are They Unique to Lithium?
TLDR
Substantial reduction of risks of suicide and attempts with long-term lithium treatment, particularly in depressive phases of BD and in MDD, and in mixed (agitated-dysphoric) states than in manic or hypomanic periods. Expand
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