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A Monograph Series Devoted To The Understanding Of Medicine, Mental Health, Man, Mind, Music And Their Matrix
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REVIEW ARTICLE
Year : 2012  |  Volume : 10  |  Issue : 1  |  Page : 33-44

Suicide and antidepressants: What current evidence indicates


Department of Psychiatry, C.S.M. Medical University, Lucknow, U.P. - 226 003, India

Correspondence Address:
J K Trivedi
Department of Psychiatry, C.S.M. Medical University, Shahmeena Road, Chowk, Lucknow - 226 003, U.P.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1229.87287

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The documented efficacy and long-term benefit of antidepressants in patients with recurrent forms of severe anxiety or depressive disorders support their use in those individuals with these disorders, who experience suicidal thoughts or behavior. In general, it is assumed that antidepressants are beneficial for all symptoms of depression, including suicidality. However, some evidence suggests that Selective Serotonin Reuptake Inhibitors [SSRIs] may cause worsening of suicidal ideas in vulnerable patients. Systematic reviews and pooled analysis of experimental, observational, and epidemiological studies have investigated the use of SSRIs and their association with suicidality. Taking account of the methodological limitations of these studies, the current evidence fails to provide a clear relationship between their use and risk of suicidality in adults. However, in children and adolescents, there appears to be a bit of increased risk of suicidal ideations and attempts, but not of completed suicides. This risk can be anticipated and managed clinically. Clinicians are, therefore, advised to maintain a close follow-up during the initial treatment periods and remain vigilant of this risk. This advisory, however, should not deter clinicians from the use of effective dosages of antidepressants for a sufficient period of time, in every age group of patients, when clinically needed, and if found suitable otherwise.


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