When the CDC released data revealing an increasing suicide rate in the US, some experts, speaking to major media outlets, speculated that the increase could be tied to the FDA’s Black Box warning for teen suicides on antidepressants. It was suggested that the warnings may discourage some from taking antidepressants and that these drugs may prevent suicides. The research, however, does not appear to support these claims. A new review of studies on the role of antidepressants in suicide, published this month in the journal of Psychotherapy and Psychosomatics, concludes that there is no evidence that antidepressants prevent suicide and that the research may even suggest that the drugs increase the risk.
“Therapists should be aware of the lack of proof from RCTs that antidepressants prevent suicides and suicide attempts.”
The MIA headline for this abstract seems a little misleading and readers of the abstract are bound to be disappointed. The abstract reads ‘It is unclear whether anti depressants prevent suicide or suicide attempts’ not
‘Anti depressants do not prevent Suicide’ as stated in the MIA caption
Yes, but I think the proper SCIENTIFIC conclusion is that they do not prevent suicide. Scientific hypotheses are held to be false until proven otherwise, and the burden of proof is on those claiming there is a positive effect. This shows that there is no evidence of a positive effect over many studies, and the trend suggests it is more likely that a negative effect is present, as even in the non-significant result studies, there were still more suicides and suicidal ideation in the antidepressant arms. Hence, a rational scientist must conclude that the data does not support the hypothesis that suicide rates are decreased by antidepressant use, and for all intents and purposes, we have to conclude that there is no such effect.
Unfortunately, many scientists are not rational on this particular point. Wanting something to be true or thinking that it should be true is not relevant to science, though it appears to be quite relevant to marketing!
That part of the abstract you quoted is the background, not the conclusion of the paper. The main point is that they found no evidence that antidepressants prevent suicide.
And what’s sad is the psychiatrists want the right to force ECT on all people who are not helped with these ineffective drugs. Anything to cover up the ineffectiveness and harm of their “wonder drugs” – what does one say about an industry of people who care more about the reputation of the inanimate drugs they prescribe, than they do about the reputations of those they are supposed to be caring for?
This is evidence that forced psychiatric treatment should be banned, however.
Hmm, going to write a post or News Story about this too?
Only if it fits the narrative, right?
Reduction of prescribed citalopram dosages to a new safety limit was associated with a higher rate of hospitalization in a large patient population who had been treated with substantially higher dosages. Stipulating a safety limit for citalopram dosages before the benefits and risks of doing so were firmly established appears to have had unintended clinical consequences.”
Just trying to educate the masses…
Joel Hassman, MD
Does the study control for withdrawal impacts, euphemistically known as “discontinuation effects?”
Also note that you’re quoting a single study, whereas the article is referencing a review of the literature, which as I’m sure you are aware is considered a much more accurate way of assessing the overall impact of a particular intervention, as individual studies are always prone to both bias and more random fluctuations that appear to be significant, hence the emphasis on replicability in all areas of science.
But I’m sure I’m preaching to the converted on that point, nec pas?
The point was lowering the dose, not stopping it. Pay attention to what is discontinuation syndrome, it means discontinued.
And yes, it was just one study, but, one can accumulate a group of “studies” that allegedly support a hypothesis, but is there full transparency what is the intent, just to find negatives and ignore there could be a plethora of other studies that show benefits?
Yeah, here there is such pervasive transparency. Starting with the predominance of people who go by aliases. Besides, the affected population were our vets, but, do they count as an important population here in America?
Cue a recent article in USA Today:
“Suicides across the military rose precipitously from 2005 to 2009 and have remained at record numbers since then, according to Pentagon data. The most recent suicide rate provided by the Pentagon, for 2014, is 19.9 per 100,000. The national civilian rate for that year was 12.93 per 100,000, according to the American Foundation for Suicide Prevention.”
How many readers here are outraged by that stat? Oh, they are not really depressed, just affected by the misuse of meds, hmm?
I’m curious, how many other psychiatrists comment at MIA these days who don’t regurgitate the mission statement here, eh, Steve?
We do the best we can with what society has pigeonholed us into, and I still don’t see posts here that accept mental health is a legitimate problem that needs care, forget meds for a minute, and I am not talking about this section of “in the news”.
And getting back to the point of this post’s article and thread, yeah, citalopram ain’t perfect, but it is better than some other SSRIs, like Paxil, which I haven’t written a starting prescription for in about 10 years now. And not a big fan of how Forrest tried to make Lexapro the second coming of Christ, at the expense of their parent medication Celexa, Citalopram.
I pay attention to agendas, as I espouse principles. One of my main principles is helping people help themselves. Can this site honestly and truly say that for the public?
Just my opinion, from what I read here. But, the “in the news” section has been educational and informative at times, hence why I come here.
Happy Memorial Day upcoming to you and all.
Joel Hassman, MD
Partly reducing the dose will still produce discontinuation symptoms. You don’t need to go complete off the drug. If you go from 80mg down to 40mg then you will almost certainly get withdrawal symptoms that can be easily mistaken as a “return of the original condition”. This study illustrates how dangerous it can be to rapidly discontinue these drugs.
Forgive me Dr Hassman, I’m confused. Are you saying that the safety of citalopram was an issue to the degree that there was a dose limit applied to it, and that the reduction in dose for SAFETY reasons resulted in people becoming more seriously ill, to the point of being hospitalised? And are you implying that this was a bad thing to do? That to reduce a drug dose because it, I assume. caused unreasonable harm, did itself cause harm? My confusion is that if the drug at high levels causes harm, and at lower levels also causes harm, why do we use it at all?