Anti-depressants can increase suicide risk, study finds

Albrecht Dürer's “Melencolia I” (1514). Keystone/eddy Risch

A Swiss-Austrian research project has found that the risk of suicide in patients suffering from depression can rise during the beginning phase of a course of medication.

Researchers from the Zurich University of Applied Sciences (ZHAW) and the University of Salzburg in Austria conducted a meta-analysis of all studies published on the subject – which were verified by the American Food and Drug Administration – between 1987 and 2013.

The results showed that, globally, 0.8% of patients who went on anti-depressants tried to commit suicide, as opposed to 0.3% of those who took a placebo.

One in every 202 patients proceeded to a suicide, or a suicide attempt, that would have been avoidable had they not been on medication, the report – published in the Psychotherapy and Psychosomatics magazine – found.

The researchers also extrapolated from the data to come up with a figure for Switzerland of 3,600 extra suicides or attempts during the period studied.

Alternatives

The scientists didn’t blanketly criticize the use of anti-depressants but did call for caution. 

“At the beginning of treatment, or in cases of an abrupt change in dosage, or when medication is stopped, we have to contend with a heightened suicide risk,” ZHAW’s Michael Hengartner said.

Dr Hengartner also mentioned the problem of over-prescription, and anti-depressants being prescribed by family doctors for “light” cases in which symptoms such as despondency, general worrying, or bad sleep are “pathologized”.

Alternative routes to recovery, such as psychotherapy or sports, should also be considered, he said.

Some 730,000 people take anti-depressants in Switzerland, a country of around 8.5 million.