Talk:Selective serotonin reuptake inhibitor

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[edit] September 2007 indicates LESS suicides in subjects taking SSRI, not more.

In quotation from the article: "Brown found that suicide attempts were dramatically lowered once antidepressant medication began, indicating an overall benefit of these newer medications. Also, very few people who died from suicide had been taking antidepressants.

He also found consistent reductions in suicide across counties as well as across countries during the time when there was increased use of antidepressants. Now that the overall level of antidepressants have decreased since the FDA warnings, there is very early evidence of an upturn in youth suicides.

"With the FDA warnings there has been a rapid lowering of antidepressant prescriptions, and there has been a corresponding increase in youth suicides" noted Brown. "We found similar results in the Netherlands once the warning was broadcast there as well."

How did the misconception that this study shows a higher tendency sneak into the article? I'm changing that. Hugi (talk) 00:52, 29 May 2008 (UTC)

I've just been through the SSRI and aggresssion section and sub-sections like a blowtorch through an ice cube. I am certain there are reliable sources that discuss the relationship, Breggin is one of them, but the referencing was terrible and some references outright contradicted the statements contained in the article. I'm sure a portion of this is a limitation of full-text versus abstract, but if the abstract says X reduced suicide, it's mis-representation to quote mine the article for only the cirtical statements without demonstrating the main conclusion. Blech. I would dearly love to see the links between SSRIs and suicide to appear in the article, but not based on blogs and fake sources. WLU (talk) 19:01, 29 May 2008 (UTC)

[edit] Suicidality in children

Based on the references and the discussion above, I changed "causes suicidality" to "may increase the risk of suicidality", since there seems to be significant controversy on this issue in the literature. This was reverted with a suggestion to discuss the change here. I'd say that "causes" is too strong, especially given the results of the Brown study discussed above. Klausness (talk) 13:42, 6 June 2008 (UTC)

First of all, both the FDA and MHRA (the UK regulatory agencies) hold that antidepressants in general, including SSRIs, cause suicidality in children (emphasis mine). These conclusions were made after the careful, case-by-case analysis of the occurrences of suicidality in double blind trials on children. I am not kidding, the FDA actually hired a group of suicidology experts from Columbia University who went, one-by-one, through the raw descriptions of all the suspicious cases of suicidality in childrens trials FDA requested fron the companies. The statistically significant increase of suicidality in double-blind trials in the antidepressant groups as compared to placebo was demonstrated beyond any doubt. If a double-blind trial demonstrates some effect it is generally hold to be causal. (Otherwise you would have to agree with such ridiculous statements as: Antibiotics are associated with improvement of acute bacterial infections, but they may not be the cause of this improvement). Thus there are warnings in the US regarding the use of antidepressants in children, and outright counterindication of such use in the UK.

On the other hand, the Brown study included adult patients, for whom the consensus is that antidepressants does not cause suicidality. In addition, the Brown study is not controlled but epidemiological, so it is inherently weaker. Paul Gene (talk) 14:42, 6 June 2008 (UTC)

I understand that these conclusions were reached after careful analysis, but many experts apparently disagree. Also, the standard way to talk about untoward side effects that occur for some, but not most, people is to say something like "may cause". To the lay person (and wikipedia is written for the lay person), "causes suicidality" means "if you take this, you will become suicidal", and that's clearly not true. My wording of "may increase the risk of suicidality" means "if you take this, you may become suicidal (or more suicidal)", which is exactly what the FDA and MHRA concluded. We could also say "increases the risk of suicidality" -- that way it sounds more definitive while still making it clear that we're talking about an increased likelihood, not a certainty. Klausness (talk) 15:18, 6 June 2008 (UTC)

I am going to change it to "can cause" like with sexual side effects: "SSRIs can cause various types of sexual dysfunction such as...". There is about the same level of certainty. Paul Gene (talk) 16:33, 6 June 2008 (UTC)