Young adults under the age of 25 suffer an increased risk of suicide or suicidal thoughts when they take antidepressants and the risk is greatest after they take the drugs for anxiety and other mental problems not connected with depression, a study has found.
The same research concluded that antidepressants had a small but noticeable effect on protecting older people against suicide. However, the increased suicide risk to the under-25s was similar to that already seen in children and adolescents taking the drugs, scientists said.
Marc Stone, medical officer of the centre for drug evaluation and research at the US Food and Drug Administration (FDA) in Silver Spring, Maryland, said: "It doesn't mean that these drugs shouldn't be given to young adults but you have to think about the risks and the benefits. The findings tell you to watch people carefully. If someone on antidepressants talks of being suicidal, it may actually be due to the drugs."
When the scientists looked at the risks of suicide, attempted suicide or suicidal thoughts in the adult population as a whole they did not find any link between the use of antidepressants and an increased suicidal risk. But when they broke the data down into different age groups, a pattern emerged.
The study investigated previous clinical trials involving 12 antidepressants from eight different drug manufacturers, including older tricyclic antidepressants, as well as the newer selective serotonin re-uptake inhibitors, such as Prozac made by Eli Lilly, and Seroxat made by GlaxoSmithKline, which was prescribed to about 400,000 Britons last year.
In the cases of nearly 100,000 patients who were randomly given either an antidepressant or a harmless dummy pill and questioned about their suicidal thoughts or behaviour, there were eight suicides, 134 suicide attempts, 10 patients who had prepared for suicide without actually attempting it and 378 patients who had admitted to thoughts about suicide but had not acted on them. The study is published online in the British Medical Journal today although the findings were originally released by the FDA two years ago.
Professor John Geddes, an epidemiological psychiatrist at Oxford University, said it is important that patients taking antidepressants continued with their medication.
The Medicines Healthcare Products Regulatory Agency advises that patients taking SSRIs and related antidepressants, particularly young adults, should be carefully monitored during treatment for any worsening of symptoms or suicidal behaviour, a spokeswoman said.