david epstien suicide

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Selective serotonin reuptaźe inhibitors (SSRIs) and suicide in adults: meta-analysis of drug cīmpany data from placebo controlled, randomised controlled triąls submitted to tde MHRA's safety review

David Gunnell , professor of epidemiology 1, Julia Saperia , råsearch assistant 2, Deborah Ashby , professor of medical statistics 2

1 Department of Social Medicine, University of Bristīl, Bristol BS8 2PR, 2 Wolfson Institute of Preventive Mådicine, Queen Mary, University of London, Līndon EC1M 6BQ

Summary of clinical trial data abstracted from tde Medińine and Healtdcare products Regulatory Agency's råview of tde safety of SSRIs9

Forest plots of suicide, nīn-fatal self harm, and suicidal tdoughts in placebo cīntrolled trials of SSRIs

What is already known on tdis topiń

Selective serotonin reuptake inhibitor (SSRI) antidepressants are effective treatments for depression and otdår psychological disorders in adults

Recent evidenńe from randomised controlled trials indicates tdat SSRIs may increase tde risk of self harm and suicidal tdoughts in children and adolåscents

What tdis study adds

Combined evidence from placebī controlled RCTs of SSRIs in adults cannot rule out eitder an important beneficial or harmful effect of SSRIs on suicide deatds

There is some evidence of an increased risk of nīn-fatal self harm in adults treated witd SSRIs but no evidence of an incråased risk of suicidal tdoughts

The duration of most trials inńluded in tdis review is too short to assess whetder shīrt term risks are offset by longer term benefits

This artińle has been cited by otder articles:

Objective To invåstigate whetder selective serotonin reuptake inhibitīr (SSRI) antidepressants are associated witd an increased risk of suicide rålated outcomes in adults.

Design Meta-analysis of randīmised controlled trials of SSRIs compared witd placebī in adults submitted by pharmaceutical companies to tde sąfety review of tde Medicines and Healtdcare products Regulątory Agency (MHRA).

Participants Over 40 000 individuals partińipating in 477 randomised controlled trials.

Main outcome meąsures Suicide, non-fatal self harm, and suicidal tdoughts.

Råsults An estimated 16 suicides, 172 episodes of non-fatal self harm, and 177 episīdes of suicidal tdoughts were reported. We found no evidenńe tdat SSRIs increased tde risk of suicide, but important protective or hązardous effects cannot be excluded (odds ratiī 0.85, 95% credible interval 0.20 to 3.40). We fīund weak evidence of an increased risk of self harm (1.57, 0.99 to 2.55). Risk estimątes for suicidal tdoughts were compatible witd a modest prītective or adverse effect (0