Skip to main content
SpringerLink
Log in

Antidepressant Medications and Suicide Risk: What Was the Impact of FDA Warning?

  • Chapter
  • First Online:
Book cover Melatonin, Neuroprotective Agents and Antidepressant Therapy

  • 1618 Accesses

Abstract

Suicide is one of the most relevant public health pathological behavior worldwide and is frequently associated with major depression. Antidepressant (AD) medications are usually considered as a treatment of first choice although evidence that AD drugs may stimulate suicidality especially in children and adolescents has been reported. In 2004, the Food and Drug Administration (FDA) issued a black boxed warning for AD treatment in these populations, but no concluding evidence has been found to date. This chapter aimed to review the current literature concerning the effect of AD medications on suicidality together with discussing the effects of FDA warning on AD prescription volumes and suicidality in the different age groups. Moreover, future perspectives based on recent pharmacogenomic findings and updated clinical management strategies will be discussed in order to provide some further understandings and practical suggestions to better manage this debated topic.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. World Health Organization. Preventing suicide: a global imperative. Luxemburg: WHO; 2014.

    Google Scholar 

  2. Mann JJ, Apter A, Bertolote J, Beautrais A, Currier D, Haas A, et al. Suicide prevention strategies: a systematic review. JAMA. 2005;294:2064–74.

    Article  CAS  PubMed  Google Scholar 

  3. Levi F, La Vecchia C, Lucchini F, Negri E, Saxena S, Maulik PK, et al. Trends in mortality from suicide, 1965–99. Acta Psychiatr Scand. 2003;108:341–9.

    Article  CAS  PubMed  Google Scholar 

  4. Tondo L, Baldessarini RJ, Hennen J, Minnai GP, Salis P, Scamonatti L, et al. Suicide attempts in major affective disorder patients with comorbid substance use disorders. J Clin Psychiatry. 1999;60 Suppl 2:63–9.

    PubMed  Google Scholar 

  5. Tondo L, Isacsson G, Baldessarini RJ. Suicide in bipolar disorder: risk and prevention. CNS Drugs. 2003;17:491–511.

    Article  CAS  PubMed  Google Scholar 

  6. Roy A. Suicide. In: Sadock BJ, Sadock VA, editors. Kaplan and Sadock’s comprehensive textbook of psychiatry, vol. 2. 7th ed. Philadelphia: Lippincott Willians and Wilkins; 2000. p. 2031–40.

    Google Scholar 

  7. American Psychiatric Association (APA). Practice guideline for the assessment and treatment of patients with suicidal behaviors. Am J Psychiatry. 2003;160(11 Suppl):1–60.

    Google Scholar 

  8. Harris EC, Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry. 1997;170:205–28.

    Article  CAS  PubMed  Google Scholar 

  9. Cassano P, Fava M. Depression and public health: an overview. J Psychosom Res. 2002;53:849–57.

    Article  PubMed  Google Scholar 

  10. Koukopoulos A, Koukopoulos A. Agitated depression as a mixed state and the problem of melancholia. Psychiatr Clin N Am. 1999;22:547–64.

    Article  CAS  Google Scholar 

  11. Akiskal HS, Benazzi F, Perugi G, Rihmer Z. Agitated “unipolar” depression re-conceptualized as a depressive mixed state: implications for the antidepressant-suicide controversy. J Affect Disord. 2005;85:245–58.

    Article  PubMed  Google Scholar 

  12. Maj M, Pirozzi R, Magliano L, Fiorillo A, Bartoli L. Agitated “unipolar” major depression: prevalence, phenomenology, and outcome. J Clin Psychiatry. 2006;67:712–9.

    Article  PubMed  Google Scholar 

  13. Arroll B, Elley CR, Fishman T, Goodyear-Smith FA, Kenealy T, Blashki G, et al. Antidepressants versus placebo for depression in primary care. Cochrane Database Syst Rev. 2009;(3):CD007954.

    Google Scholar 

  14. Gibbons RD, Brown CH, Hur K, Davis JM, Mann JJ. Suicidal thoughts and behavior with antidepressant treatment: reanalysis of the randomized placebo-controlled studies of fluoxetine and venlafaxine. Arch Gen Psychiatry. 2012;69(6):580–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Stone M, Laughren T, Jones TL, Levenson M, Holland PC, Hughes A, et al. Risk of suicidality in clinical trials of antidepressants in adults: analysis of proprietary data submitted to US Food and Drug Administration. BMJ. 2009;339:b2880.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Friedman RA, Leon AC. Expanding the black box—depression, antidepressants, and the risk of suicide. N Engl J Med. 2007;356:2343–6.

    Article  CAS  PubMed  Google Scholar 

  17. Hall WD. How have the SSRI antidepressants affected suicide risk? Lancet. 2006;367:1959–62.

    Article  PubMed  Google Scholar 

  18. King RA, Riddle MA, Chappell PB, Hardin MT, Anderson GM, Lombroso P, et al. Emergence of self-destructive phenomena in children and adolescents during fluoxetine treatment. J Am Acad Child Adolesc Psychiatry. 1991;30:179–86.

    Article  CAS  PubMed  Google Scholar 

  19. Gordon MS, Melvin GA. Do antidepressants make children and adolescents suicidal? J Ped Child Health. 2014;50(11):847–54.

    Article  Google Scholar 

  20. Hammad TA. Review and evaluation of clinical data. TGA. 2004. Available from: http://www.fda.gov/ohrms/dockets/ac/04/briefing/2004-4065b1-10-TAB08-Hammads-Review.pdf. Accessed 13 Jul 2015.

  21. Isacsson G, Rich CL. Antidepressant drugs and the risk of suicide in children and adolescents. Paediatr Drugs. 2014;16(2):115–22.

    Article  PubMed  Google Scholar 

  22. Friedman RA. Antidepressants’ black-box warning – 10 years later. N Engl J Med. 2014;371(18):1666–8.

    Article  PubMed  Google Scholar 

  23. Laughren TP. Overview for December 13 meeting of Psychopharmacologic Drugs Advisory Committee (PDAC). 2006. www.fda.gov/ohrms/dockets/ac/06/briefing/2006-4272b1-01-FDA.pdf. Accessed 6 Jul 2015.

  24. Gøtzsche PC. Deadly medicines and organised crime: how big pharma has corrupted health care. London: Radcliffe Publishing; 2013.

    Google Scholar 

  25. Gibbons RD, Brown CH, Hur K. Early evidence on the effects of regulators’ suicidality warnings on SSRI prescriptions and suicide in children and adolescents. Am J Psychiatry. 2007;164:1356–63.

    Article  PubMed  Google Scholar 

  26. Stone MB. The FDA, warning on antidepressants and suicidality—why the controversy? N Engl J Med. 2014;371(18):1668–71.

    Article  PubMed  Google Scholar 

  27. Case BG. More data needed to interpret link between suicide and FDA warning on antidepressants. BMJ. 2014;349:g5616.

    Article  PubMed  Google Scholar 

  28. Lu CY, Zhang F, Lakoma MD, Madden JM, Rusinak D, Penfold RB, et al. Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study. BMJ. 2014;348:g3596.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Libby AM, Orton HD, Valuck RJ. Persisting decline in depression treatment after FDA warnings. Arch Gen Psychiatry. 2009;66:633–9.

    Article  PubMed  Google Scholar 

  30. Mittal VM, Brown CH, Prior HJ, Marcus SC, Greenberg T. Trend of antidepressants prescriptions in the pedriatric population before and the FDA warning: a follow up study. Arch Pediatr. 2013;26(10):1319–31.

    Google Scholar 

  31. Clarke G, Dickerson J, Gullion CM, DeBar LL. Trends in youth antidepressant dispensing and refill limits, 2000 through 2009. J Child Adolesc Psychopharmacol. 2012;22(1):11–20.

    Article  PubMed  Google Scholar 

  32. Reeves RR, Ladner ME. Antidepressant-induced suicidality: an update. CNS Neurosci Ther. 2010;16(4):227–34.

    PubMed  Google Scholar 

  33. Katz LY, Kozyrskyj AL, Prior HJ, Enns MW, Cox BJ, Sareen J. Effect of regulatory warnings on antidepressant prescription rates, use of health services and outcomes among children, adolescents and young adults. CMAJ. 2008;178(8):1005–11.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Wijlaars LP, Nazareth I, Petersen I. Trends in depression and antidepressant prescribing in children and adolescents: a cohort study in The Health Improvement Network (THIN). PLoS One. 2012;7(3):e33181.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Olfson M, Shaffer D, Marcus SC, Greenberg T. Relationship between antidepressant medication treatment and suicide in adolescents. Arch Gen Psychiatry. 2003;60:978–82.

    Article  PubMed  Google Scholar 

  36. Olfson M, Schoenbaum M. Link between FDA antidepressant warnings and increased suicide attempts in young people is questionable. BMJ. 2014;349:g5614.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Nardo JM. Impossible to draw meaningful conclusions from study of changes in antidepressant use after FDA warnings. BMJ. 2014;349:g5643.

    Article  PubMed  Google Scholar 

  38. Barber C, Azrael D, Miller M. Study findings on FDA antidepressant warnings and suicide attempts in young people: a false alarm? BMJ. 2014;349:g5645.

    Article  CAS  PubMed  Google Scholar 

  39. Moore TJ. Antidepressants increase, rather than decrease, risk of suicidal behaviours in younger patients. BMJ. 2014;349:g5626.

    Article  PubMed  Google Scholar 

  40. Lu CY, Simon G, Soumerai SB. Authors’ reply to Olfson and Schoenbaum, Nardo, Bartlett, Moore, Case, Gøtzsche, and Barber and colleagues. BMJ. 2014;349:g5722.

    Article  PubMed  Google Scholar 

  41. Xiang Y, Zhao W, Xiang H, Smith GA. ED visits for drug-related poisoning in the United States. Am J Emerg Med. 2012;30:293–301.

    Article  PubMed  Google Scholar 

  42. Nock MK, Green JG, Hwang I, McLaughlin KA, Sampson NA, Zaslavsky AM, et al. Prevalence, correlates and treatment of lifetime suicidal behavior among adolescents: results from the National Comorbidity Survey Replication Adolescent Supplement. JAMA Psychiatr. 2013;70:300–10.

    Article  Google Scholar 

  43. Bailly D. Antidepressant use in children and adolescents. Arch Pediatr. 2009;16(10):1415.

    Article  CAS  PubMed  Google Scholar 

  44. Leon AC, Solomon DA, Li C, Fiedorowicz JG, Coryell WH, Endicott J, et al. Antidepressants and risks of suicide and suicide attempts: a 27-year observational study. J Clin Psychiatry. 2011;72(5):580–6.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Isacsson G, Holmgren P, Ahlner J. Selective serotonin reuptake inhibitor antidepressants and the risk of suicide: a controlled forensic database study of 14,857 suicides. Acta Psychiatr Scand. 2005;111:286–90.

    Article  CAS  PubMed  Google Scholar 

  46. Centers for Disease Control and Prevention. Web-based Injury Statistics Query and Reporting System (WISQARS). 2003. www.cdc.gov/ncipc/wisqars. Accessed 6 Jul 2015.

  47. California Department of Public Health, Safe and Active Communities Branch. http://epicenter.cdph.ca.gov. Accessed 13 Jul 2015.

  48. Mosholder AD, Willy M. Suicidal adverse events in pediatric randomized, controlled clinical trials of antidepressant drugs are associated with active drug treatment: a meta-analysis. J Child Adolesc Psychopharmacol. 2006;16:25–32.

    Article  PubMed  Google Scholar 

  49. Hammad TA, Laughren T, Racoosin J. Suicidality in pediatric patients treated with antidepressant drugs. Arch Gen Psychiatry. 2006;63:332–9.

    Article  CAS  PubMed  Google Scholar 

  50. Bridge JA, Iyengar S, Salary CB, Barbe RP, Birmaher B, Pincus HA, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA. 2007;297(15):1683–96.

    Article  CAS  PubMed  Google Scholar 

  51. Wohlfarth TD, van Zwieten BJ, Lekkerkerker FJ, et al. Antidepressants use in children and adolescents and the risk of suicide. Eur Neuropsychopharmacol. 2006;16:79–83.

    Article  CAS  PubMed  Google Scholar 

  52. March JS, Klee BJ, Kremer CM. Treatment benefit and the risk of suicidality in multicenter, randomized, controlled trials of sertraline in children and adolescents. J Child Adolesc Psychopharmacol. 2006;16:91–102.

    Article  PubMed  Google Scholar 

  53. Kaizar EE, Greenhouse JB, Seltman H, Kelleher K. Do antidepressants cause suicidality in children? A Bayesian meta-analysis. Clin Trials. 2006;3:73–98.

    Article  PubMed  Google Scholar 

  54. Hammad TA, Mosholder AD. Suicide and antidepressants. Beware extrapolation from ecological data. BMJ. 2010;341:c6844.

    Article  PubMed  Google Scholar 

  55. Pamer C, Hammad TA, Yu T, Kaplan S, Rochester G, Governale L, et al. Changes in US antidepressant and antipsychotic prescription patterns during a period of FDA actions. Pharmacoepidemiol Drug Safe. 2010;19:158–74.

    Article  Google Scholar 

  56. Centers for Disease Control and Prevention. Youth risk behavior surveillance system. Trends in the prevalence of suicide-related behaviours. National YRBS: 1997–2011. www.cdc.gov/healthyyouth/yrbs/pdf/us_suicide_trend_yrbs.pdf. Accessed 13 Jul 2015.

  57. Gibbons RD, Hur K, Bhaumik DK, Mann JJ. The relationship between antidepressant prescription rates and rate of early adolescent suicide. Am J Psychiatry. 2006;163(11):1898–904.

    Article  PubMed  Google Scholar 

  58. Hall WD, Lucke J. How have the selective serotonin reuptake inhibitor antidepressants affected suicide mortality? Aust N Z J Psychiatr. 2006;40:941–50.

    Article  Google Scholar 

  59. Søndergård L, Kvist K, Andersen PK, Kessing LV. Do antidepressants precipitate youth suicide? Eur Child Adolesc Psychiatry. 2006;5:232–40.

    Article  Google Scholar 

  60. Simon GE, Savarino J. Suicide attempts among patients starting depression treatment with medications or psychotherapy. Am J Psychiatry. 2007;164:1029–34.

    Article  PubMed  Google Scholar 

  61. Leon AC, Demirtas H, Li C, Hedeker D. Two propensity score-based strategies for a three-decade observational study: investigating psychotropic medications and suicide risk. Stat Med. 2012;31(27):3255–60.

    Article  PubMed  Google Scholar 

  62. Kamat MA, Edgar L, Niblock P, McDowell C, Kelly CB. Association between antidepressant prescribing and suicide rates in OECD countries: an ecological study. Pharmacopsychiatry. 2014;47(1):18–21.

    CAS  PubMed  Google Scholar 

  63. Tiihonen J, Lonnqvist J, Wahlbeck K, Klaukka T, Tanskanen A, Haukka J. Antidepressants and the risk of suicide, attempted suicide, and overall mortality in a nationwide cohort. Arch Gen Psychiatry. 2006;63:1358–67.

    Article  CAS  PubMed  Google Scholar 

  64. Gusmão R, Quintão S, McDaid D, Arensman E, Van Audenhove C, Coffey C, et al. Antidepressant utilization and suicide in Europe: an ecological multi-national study. PLoS One. 2013;8(6):e66455.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Leon AC, Marzuk PM, Tardiff K, Teres JJ. Paroxetine, other antidepressants, and youth suicide in New York City: 1993 through 1998. J Clin Psychiatry. 2004;65:915–8.

    Article  PubMed  Google Scholar 

  66. Leon AC, Marzuk PM, Tardiff K, Bucciarelli A, Markham, Piper T, et al. Antidepressants and youth suicide in New York City, 1999–2002. J Am Acad Child Adolesc Psychiatry. 2006;45:1054–8.

    Article  PubMed  Google Scholar 

  67. Singh VD, Lathrop SL. Youth suicide in New Mexico: a 26-year retrospective review. J Forensic Sci. 2008;53:703–8.

    Article  PubMed  Google Scholar 

  68. Cortes E, Cubano A, Lewis JE, Castellanos D. Antidepressants at autopsy in hispanic suicidal youth in Miami-Dade County. Florida J Forensic Sci. 2011;56:155–60.

    Article  PubMed  Google Scholar 

  69. Wasserman D, Wasserman C. The Oxford textbook of suicidology and suicide prevention. Oxford: Oxford University Press; 2011.

    Google Scholar 

  70. Gibbons RD, Hur K, Brown CH, Davis JM, Mann JJ. Benefits from antidepressants: synthesis of 6-week patient-level outcomes from double-blind placebo-controlled randomized trials of fluoxetine and venlafaxine. Arch Gen Psychiatry. 2012;69(6):572–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  71. Erlangsen A, Conwell Y. Age-related response to redeemed antidepressants measured by completed suicide in older adults: a nationwide cohort study. Am J Geriatr Psychiatry. 2014;22(1):25–33.

    Article  PubMed  Google Scholar 

  72. Phillips JA, Nugent CN. Antidepressant use and method of suicide in the United States: variation by age and sex, 1998–2007. Arch Suicide Res. 2013;17(4):360–72.

    Article  PubMed  Google Scholar 

  73. Gunnell D, Saperia J, Ashby D. Selective serotonin reuptake inhibitors (SSRIs) and suicide in adults: meta-analysis of drug company data from placebo controlled, randomised controlled trials submitted to the MHRA’s safety review. BMJ. 2005;330:385–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Fergusson D, Doucette S, Glass KC, Shapiro S, Healy D, Hebert P, et al. Association between suicide attempts and selective serotonin reuptake inhibitors: systematic review of randomised controlled trials. BMJ. 2005;330(7488):396.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Shah A, Zhinchin G, Zarate-Escudero S, Somyaji M. The relationship between the prescription of psychotropic drugs and suicide rates in older people in England and Wales. Int J Soc Psychiatry. 2014;60(1):83–8.

    Article  PubMed  Google Scholar 

  76. Brent D. Effective treatments for suicidal youth: pharmacological and psychosocial approaches. In: Wasserman D, Wasserman C, editors. The Oxford textbook of suicidology and suicide prevention. Oxford: Oxford University Press; 2011. p. 667–76.

    Google Scholar 

  77. Julious SA. Efficacy and suicidal risk for antidepressants in paediatric and adolescent patients. Stat Methods Med Res. 2013;22(2):190–218.

    Article  PubMed  Google Scholar 

  78. Hetrick SE, McKenzie JE, Merry SN. The use of SSRIs in children and adolescents. Curr Opin Psychiatr. 2010;23:53–7.

    Article  Google Scholar 

  79. Henry A, Kisicki MD, Varley C. Efficacy and safety of antidepressant drug treatment in children and adolescents. Mol Psychiatry. 2012;17(12):1186–93.

    Article  CAS  PubMed  Google Scholar 

  80. Hetrick SE, McKenzie JE, Cox GR, Simmons MB, Merry SN. Newer generation antidepressants for depressive disorders in children and adolescents. Cochrane Database Syst Rev. 2012;(11):CD004851.

    Google Scholar 

  81. Coupland C, Hill T, Morriss R, Arthur A, Moore M, Hippisley-Cox J. Antidepressant use and risk of suicide and attempted suicide/self-harm in people aged 20 to 64: cohort study using a primary care database. BMJ. 2015;350:h517.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Coupland C, Dhiman P, Morriss R, Arthur A, Barton G, Hippisley-Cox J. Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ. 2011;343:d4551.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Schneeweiss S, Patrick AR, Solomon DH, Mehta J, Dormuth C, Miller M, et al. Variation in the risk of suicide attempts and completed suicides by antidepressant agent in adults: a propensity score-adjusted analysis of 9 years’ data. Arch Gen Psychiatry. 2010;67:497–506.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Hawton K, Bergen H, Simkin S, Cooper J, Waters K, Gunnell D, et al. Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose. Br J Psychiatry. 2010;196:354–8.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R, et al. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet. 2009;373:746–58.

    Article  CAS  PubMed  Google Scholar 

  86. Watanabe N, Omori IM, Nakagawa A, Cipriani A, Barbui C, Churchill R, et al. Mirtazapine versus other antidepressive agents for depression. Cochrane Database Syst Rev. 2011;12:CD006528.

    Google Scholar 

  87. Garlow SJ, Kinkead B, Thase ME, Judd LL, Rush AJ, Yonkers KA, et al. Fluoxetine increases suicide ideation less than placebo during treatment of adults with minor depressive disorder. J Psychiatr Res. 2013;47(9):1199–203.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Grunebaum MF, Keilp JG, Ellis SP, Sudol K, Bauer N, Burke AK, et al. SSRI versus bupropion effects on symptom clusters in suicidal depression: post hoc analysis of a randomized clinical trial. J Clin Psychiatry. 2013;74(9):872–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  89. Makris GD, Reutfors J, Ösby U, Isacsson G, Frangakis C, Ekbom A, et al. Suicide seasonality and antidepressants: a register-based study in Sweden. Acta Psychiatr Scand. 2013;127(2):117–25.

    Article  CAS  PubMed  Google Scholar 

  90. Valenstein M, Kim HM, Ganoczy D, Eisenberg D, Pfeiffer PN, Downing K, et al. Antidepressant agents and suicide death among US Department of Veterans Affairs patients in depression treatment. J Clin Psychopharmacol. 2012;32(3):346–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Zisook S, Lesser IM, Lebowitz B, Rush AJ, Kallenberg G, Wisniewski SR, et al. Effect of antidepressant medication treatment on suicidal ideation and behavior in a randomized trial: an exploratory report from the Combining Medications to Enhance Depression Outcomes Study. J Clin Psychiatry. 2011;72(10):1322–32.

    Article  CAS  PubMed  Google Scholar 

  92. Perlis RH, Uher R, Perroud N, Fava M. Do suicidal thoughts or behaviors recur during a second antidepressant treatment trial? J Clin Psychiatry. 2012;73(11):1439–42.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Cooper WO, Callahan ST, Shintani A, Fuchs DC, Shelton RC, Dudley JA, et al. Antidepressants and suicide attempts in children. Pediatrics. 2014;133(2):204–10.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Emslie GJ, Findling RL, Yeung PP, Kunz NR, Li Y. Venlafaxine ER for the treatment of pediatric subjects with depression: results of two placebo-controlled trials. J Am Acad Child Adolesc Psychiatry. 2007;46(4):479–88.

    Article  PubMed  Google Scholar 

  95. Whittington CJ, Kendall T, Fonagy P, Cottrell D, Cotgrove A, Boddington E. Selective serotonin reuptake inhibitors in childhood depression: systematic review of published verses unpublished data. Lancet. 2004;363:1341–5.

    Article  CAS  PubMed  Google Scholar 

  96. Miller M, Pate V, Swanson SA, Azrael D, White A, Stürmer T. Antidepressant class, age, and the risk of deliberate self-harm: a propensity score matched cohort study of SSRI and SNRI users in the USA. CNS Drugs. 2014;28(1):79–88.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  97. Hysinger EB, Callahan ST, Caples TL, Fuchs DC, Shelton R, Cooper WO. Suicidal behavior differs among early and late adolescents treated with antidepressant agents. Pediatrics. 2011;128(3):447–54.

    PubMed  PubMed Central  Google Scholar 

  98. Cheung K, Aarts N, Noordam R, van Blijderveen JC, Sturkenboom MC, Ruiter R, et al. Antidepressant use and the risk of suicide: a population-based cohort study. J Affect Disord. 2015;174:479–84.

    Article  CAS  PubMed  Google Scholar 

  99. Dubicka B, Hadley S, Roberts C. Suicidal behaviour in youths with depression treated with new-generation antidepressants: meta-analysis. Br J Psychiatry. 2006;189:393–8.

    Article  PubMed  Google Scholar 

  100. Olmer A, Iancu I, Strous RD. Exposure to antidepressant medications and suicide attempts in adult depressed inpatients. J Nerv Ment Dis. 2012;200(6):531–4.

    Article  PubMed  Google Scholar 

  101. Angst J, Angst F, Gerber-Werder R, Gamma A. Suicide in 406 mood-disorder patients with and without long-term medication: a 40 to 44 years’ follow-up. Arch Suicide Res. 2005;9(3):279–300.

    Article  PubMed  Google Scholar 

  102. Peñas-Lledó E, Guillaume S, Naranjo MEG, Delgado A, Blasco-Fontecilla H, LLerena A. A combined high CYP2D6-CYP2C19 metabolic capacity is associated with the severity of suicide attempt as measured by objective circumstances. Pharmacogenomics. 2015;15(2):172–6.

    Article  CAS  Google Scholar 

  103. Stingl JC, Viviani R. CYP2D6 in the brain: impact on suicidality. Clin Pharmacol Ther. 2011;89:352–3.

    Article  CAS  PubMed  Google Scholar 

  104. Peñas-Lledó EM, Blasco-Fontecilla H, Dorado P, Vaquero-Lorenzo C, Baca-Garcia E, Llerena A. CYP2D6 and the severity of suicide attempts. Pharmacogenomics. 2012;13:179–84.

    Article  CAS  PubMed  Google Scholar 

  105. Peñas-Lledó EM, Trejo HD, Dorado P, Ortega A, Jung H, Alonso E, et al. CYP2D6 ultrarapid metabolism and early dropout from fluoxetine or amitriptyline monotherapy treatment in major depressive patients. Mol Psychiatry. 2013;18:8–9.

    Article  CAS  PubMed  Google Scholar 

  106. Lobello KW, Preskorn SH, Guico-Pabia CJ, Jiang Q, Paul J, Nichols AI, et al. Cytochrome P450 2D6 phenotype predicts antidepressant efficacy of venlafaxine: a secondary analysis of 4 studies in major depressive disorder. J Clin Psychiatry. 2010;71:1482–7.

    Article  CAS  PubMed  Google Scholar 

  107. Tsai MH, Lin KM, Hsiao MC, Shen WW, Lu ML, Tang HS, et al. Genetic polymorphisms of cytochrome P450 enzymes influence metabolism of the antidepressant escitalopram and treatment response. Pharmacogenomics. 2010;11:537–46.

    Article  CAS  PubMed  Google Scholar 

  108. Sim SC, Kacevska M, Ingelman-Sundberg M. Pharmacogenomics of drug metabolizing enzymes: a recent update on clinical implications and endogenous effects. Pharmacogenomics. 2013;13:1–11.

    Article  CAS  Google Scholar 

  109. Spielmans GI, Jureidini J, Healy D, Purssey R. Inappropriate data and measures lead to questionable conclusions. JAMA Psychiatr. 2013;70(1):121–2.

    Article  Google Scholar 

  110. Moeller HJ. Pharmacological and other biological treatments of suicidal individuals. In: Wasserman D, Wasserman C, editors. The Oxford textbook of suicidology and suicide prevention. Oxford: Oxford University Press; 2011. p. 395–405.

    Google Scholar 

  111. Williams LM, Rush AJ, Koslow SH, Wisniewski SR, Cooper NJ, Nemeroff CB, et al. International study to predict optimized treatment for depression (iSPOT-D), a randomized clinical trial: rationale and protocol. Trials. 2011;12:4.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genova, IRCCS San Martino, Largo Rosanna Benzi 10, Genova, 16100, Italy

    Gianluca Serafini MD, PhD, Paola Solano & Mario Amore

Authors
  1. Gianluca Serafini MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paola Solano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mario Amore
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gianluca Serafini MD, PhD .

Editor information

Editors and Affiliations

  1. Vice-Rectorate for Research and Sci, Camilo José Cela University Vice-Rectorate for Research and Sci, Madrid, Spain

    Francisco López-Muñoz

  2. International Medical Sciences Research Study Center, Sri Sathya Sai Medical Educational & Research Foundation, Coimbatore, India

    Venkataramanujam Srinivasan

  3. Department of Neurosciences and Ima, University of Chieti Department of Neurosciences and Ima, Italy, Italy

    Domenico de Berardis

  4. Department of Biomedical Sciences (Pharmacology Area), University of Alcalá, Madrid, Spain

    Cecilio Álamo

  5. Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan

    Takahiro A. Kato

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer India

About this chapter

Cite this chapter

Serafini, G., Solano, P., Amore, M. (2016). Antidepressant Medications and Suicide Risk: What Was the Impact of FDA Warning?. In: López-Muñoz, F., Srinivasan, V., de Berardis, D., Álamo, C., Kato, T. (eds) Melatonin, Neuroprotective Agents and Antidepressant Therapy. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2803-5_31

Download citation

  • DOI: https://doi.org/10.1007/978-81-322-2803-5_31

  • Published:

  • Publisher Name: Springer, New Delhi

  • Print ISBN: 978-81-322-2801-1

  • Online ISBN: 978-81-322-2803-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation