Antidepressant Use Does Not Prevent Suicide, Study Finds

A new study has found that antidepressants are ineffective for reducing suicide attempts. The researchers found that about 20% of participants attempted suicide after being hospitalized for depression, whether they took antidepressants or not.

The researchers found a large spike in suicides just after initiating antidepressant use: up to 4 times higher in the month just after first taking an antidepressant than in later months.

However, as there was also an increase just before taking an antidepressant, the researchers argue that this spike in suicidality is due to “disease severity” rather than the antidepressant use. The researchers conclude that antidepressants do not reduce suicidality.

Merete Osler led the study at the Bispebjerg and Frederiksberg Hospitals in Denmark. It was published in Acta Psychiatrica Scandinavica.

This research comes on the heels of a recent study that found that those taking antidepressants were 2.5 times more likely to attempt suicide than those taking a placebo, even after controlling for disease severity.

Studies have consistently found increased suicide rates for those taking antidepressants. This is especially concerning when the data involves children and adolescents. Researchers have also found missing data on adverse effects, including suicide attempts, in pharmaceutical industry studies, which makes them appear safer than they are.

According to Osler and the other researchers, suicide attempts and violent behaviors were linked to taking psychotropic medications, among other factors.

“Suicidal behavior and violent crime were most frequent among the lowest educated, those with psychiatric comorbidity or psychotropic medication,” they write.

The study, conducted in Denmark, used Danish national registries to identify participants. It included 95,794 Danes who were treated in a hospital for the first episode of an “affective disorder” such as depression. Danish registries also identified all those who filled a prescription for antidepressants.

The researchers found that suicide attempts were most likely in the month before, and the month after, taking an antidepressant. They use this data to argue against the notion that antidepressants increase suicidality. Instead, it is likely that antidepressants do not help prevent suicidality.

However, the researchers note that there was no data regarding whether people received antidepressants while they were in the hospital for depression. It may be likely that those receiving treatment in the hospital were given antidepressants as they are typically the first-line treatment for depression severe enough to necessitate hospitalization.

If they received antidepressants while in the hospital, then attempted suicide, and then filled a prescription for an antidepressant, the researchers would consider them to have attempted suicide before taking the antidepressant—even though it was after they started taking the drug.

For this reason, the finding that suicide attempts were also more likely just before filling the first prescription for an antidepressant might be caused by receiving antidepressants in the hospital.

However, the researchers concluded that “the similar incidence of suicide attempts and violence before and after the start of antidepressants argues against a causal relation between suicidal and aggressive behavior and initiation of antidepressants.”

 

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Osler, M., Wium‐Andersen, M. K., Wium‐Andersen, I. K., Gronemann, F. H., Jørgensen, M. B., Rozing, M. P. (2019). Incidence of suicidal behavior and violent crime following antidepressant medication. A Danish cohort study. Acta Psychiatrica Scandinavica. DOI:10.1111/acps.13097 (Link)