The problem of suicide in depression in the modern world

Abstract

To analyze the literature data on the relationship between antidepressant therapy and suicide risk and the ways to prevent suicidal behavior in patients on antidepressant therapy. A non-systematic review of publications was conducted using keywords in the following databases: ELibrary.ru, PubMed, Cochrane Database of Systematic Reviews. Inclusion criteria were meta-analyses, Cochrane reviews, epidemiological and original studies. Data from original studies are inconsistent, but more evidence-based epidemiologic studies support the preventive role of antidepressant therapy with regard to suicide. An increased risk of suicide with antidepressant therapy is seen in younger patients, especially in the first 2 weeks of treatment, in the absence of a therapeutic response. The initial dosage of antidepressants, possibly the type of antidepressant, is of some importance. The group at risk of committing suicide is those who have received psychotropic therapy in the previous year. There is no generally accepted model of prevention, but it is recommended that patients be observed during the first 4 weeks of treatment for depression, as well as during the period of antidepressant dose modification.