Antidepressants and Suicide: Putting the Risk in Perspective

Abstract

<P>According to the Centers for Disease Control and Prevention (CDC) (2007), more than 30,000 people in the United States died by suicide in 2001, more than 116,000 people were treated and released from emergency rooms after suicide attempts in 2002, and more than 130,000 people were hospitalized following suicide attempts in 2002. Although suicidal thoughts are a symptom of depression, and completed suicide is a tragic complication of depressive illness, in October 2004, the U.S. Food and Drug Administration (FDA) ordered that all antidepressant medications carry a warning indicating that they are associated with an increased risk of suicidal thinking, feeling, and behavior in children and adolescents. In May 2007, the FDA expanded this warning to include information about an increased risk of suicidal symptoms in young adults ages 18 to 24. </P> <H4>ABOUT THE AUTHOR</H4> <P>Dr. Howland is Associate Professor of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania. </P> <P>Address correspondence to Robert H. Howland, MD, Associate Professor of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Pittsburgh, PA 15213; e-mail: <A HREF="mailto:HowlandRH@upmc.edu">HowlandRH@upmc.edu</A>. </P> <P>Dr. Howland has disclosed no relevant financial relationships.</P> <H4>EDUCATIONAL OBJECTIVES</H4> <OL> <LI>Assess the rationale for the current Food and Drug Administration warning that antidepressant medications are associated with an increased risk of suicidal symptoms in children, adolescents, and young adults.</LI> <LI>Describe some of the problems with assessing suicide risk from randomized placebo-controlled antidepressant medication trials.</LI> <LI>Discuss relevant findings from larger population-based studies on antidepressant usage and the relative risks of suicide in real-world settings.</LI> </OL>