THE QUESTION POSED in the title of this column may strike many readers as odd. How can medications that have proved helpful in reducing depression also cause suicide? After all, suicide is a tragic complication of some cases of depression. Yet research and clinical observations over the past 40 years have raised concerns that these drugs produce suicidal thoughts, suicide attempts and possibly even suicide in a small subset of depressed patients. What are the risks?
In 2006 psychiatrist Tarek A. Hammad and his associates at the U.S. Food and Drug Administration published a meta-analysis (quantitative review) of studies involving a large number of children and adolescents taking antidepressants for depression, anxiety disorders and attention-deficit hyperactivity disorder (ADHD). Their results demonstrated that subjects on antidepressant medications had twice the risk (4 versus 2 percent) of suicidality (suicidal thoughts and attempts) as compared with those on placebo. No completed suicides occurred during any of the studies reviewed. A 2007 meta-analysis by psychologist Jeffrey Bridge of Ohio State University and colleagues at several institutions included additional studies and confirmed these results, although the percentages for suicidality were slightly lower.