Suicide Attempts Fall After Depression Treatment Begins

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The overall incidence of suicide attempts in the first six months was highest in those taking antidepressant drugs prescribed by a psychiatrist (1,124 attempts per 100,000), lower among those starting psychotherapy (778 per 100,000) and lowest of all among those who were taking antidepressants prescribed by a general practitioner (301 per 100,000).

The bottom line: "Our study indicates there is nothing specific to antidepressant medications that would either make large populations of people with depression start trying to kill themselves or protect them from suicidal thoughts," Simon said.

"Instead, we think that on average, starting any kind of treatment medication, psychotherapy or both, helps most people of any age have fewer symptoms of depression, including thinking about suicide and attempting it," he said.

The new report "is one of a couple showing that prescribing antidepressant medication for people who are depressed has the potential for reducing the number of suicide attempts," said Dr. J. John Mann, chief of the department of neuroscience at the New York Psychiatric Institute, New York City.

Mann co-authored one such report, which relied on U.S. Veterans Administration data. "We found exactly the same thing" as the Simon report, Mann said. "Antidepressant treatment resulted in lower rates of suicide attempts after people went on to treatment."

Such studies "suggest that these medications may be more beneficial than has been thought in the past," Mann said. "If there is a risk in these medications, it clearly is outweighed by the benefits. No treatment is the worst option of all."

Simon also pointed out that the FDA warning reduced use of SSRI drugs for treatment of depression, but it has not appeared to increase doctors' monitoring of young people who are taking the drugs. The standing recommendation for three follow-up visits to the therapist prescribing antidepressant drugs was observed in only 21 percent of cases, the researcher said.

"That is where we are poor in practice," Simon said. "My concern is that the practical impact of the warning was [only in] reduced rates of treatment."

More information

There is more on suicide prevention at the U.S. National Institute of Mental Health.