Startseite
Impressum
Datenschutz
 
arznei-telegramm 2008; 39: 3

 


FEWER ANTIDEPRESSANTS, MORE SUICIDES?
...Study author back-pedals

Since 2003 and 2005, respectively, the FDA and EMEA, the US and European drug authorities, have warned of increasing suicidality among children and adolescents taking antidepressants. Since then the suicide rate was said to have risen as prescriptions of antidepressants have declined; at least this was the claim of an American-Dutch correlation study in September 2007 (1). "Suicide rate in adolescents sharply increased after decline in antidepressant prescriptions" ran the title given to the story by the German medical newspaper, "Ärztezeitung", for example (2).

Although the publication goes so far as to give concrete predictions about future suicide rates with a continuing decline in the number of prescriptions, the Dutch co-author R. HERINGS is now back-pedalling: "None of the authors concluded that by underuse of antidepressants the suicide rate will increase. This is an ecological study, and we are very well aware that such conclusions about causality can not be drawn, exept that such correlations might be used to speculate about hypotheses" (3). What adds piquancy to the situation is that HERINGS, who some years ago conducted a study for Janssen-Cilag on the "increased suicide attempt rate among patients interrupting use of atypical antipsychotics" (4), conceals his conflict of interests (5) in the present correlation study (1).

Moreover, our view that the existing data do not support the claimed increase in suicidality (a-t 2007; 38: 92-3) is confirmed on two accounts. A statistician who also advises the Dutch Central Office of Statistics (CBS), which provided the Dutch data for the observational study, also questions the interpretation: he can "detect no increase in the rate of suicides in adolescents" (5). In fact, the 51 suicides of under 20-year-olds recorded by the CBS for 2005 (the last period for which Dutch data were collected in the correlation study) are within the normal range of variation (minimum: 33 suicides 2003, maximum: 56 in 1997) for all values available since 1994 (6).

The new, but still provisional figures from the US "Centers for Disease Control" also contradict the conclusion drawn in the correlation study. According to these figures, fewer under 25-year-olds committed suicide in the USA in 2005 than in 2004, the last period for which American data were collected in the study (7,8). At the same time prescriptions of SSRI for paediatric patients with depression also fell sharply in 2005 (7,9).

Despite all assertions to the contrary, no increase in suicide rates in children and adolescents can be identified as a result of the warnings about the prescription of antidepressants. Such reports, which serve the interests of the pharmaceutical industry, have proved to be a misinterpretation.


 

1

GIBBONS, R.D. et al.: Am. J. Psychiatry 2007; 164: 1356-63

 

2

Ärzte Zeitung of 19 Sept. 2007

 

3

HERINGS, R.: Letter of 10 Jan. 2008

 

4

HERINGS, R.M.C., ERKENS, J.A.: Pharmacoepidemiol. Drug Saf. 2003; 12: 423-4

 

5

Noorderlicht; http://noorderlicht.vpro.nl/artikelen/38241591/

 

6

CBS data; to be found at: http://www.cbs.nl/en-GB/default.htm

 

7

JUREIDINI, J.: Am. J. Psychiatry 2007; 164: 1907

 

8

KUNG, H.C. et al.: Deaths; Preliminary Data for 2005. Hyattsville, Md, National Center for Health Statistics, 2005; http://www.cdc.gov/nchs/products/pubs/pubd/hestats/prelimdeaths05/prelimdeaths05.htm

 

9

LIBBY, A.M. et al.: Am. J. Psychiatry 2007; 164: 884-91



© arznei-telegramm 1/08