Suicidal behaviour is more likely in the first month after starting antidepressants

As reported in the British Medical Journal, suicidal behaviour is more likely in the first month after starting antidepressants, especially during the first nine days.

The researchers—Dr Hershel Jick and colleagues with the Boston Collaborative Drug Surveillance Program, Boston University, Massachusetts—compared the risk of non-fatal suicidal behaviour in patients in the United Kingdom who began treatment with one of three antidepressants (the SSRIs fluoxetine and paroxetine and the tricyclic amitriptyline) with the risk in patients who started taking the older tricyclic dosulepin (formerly known as dothiepin).

Cases taking a single antidepressant were taken from the base population of 159,810 users of at least one of the four antidepressants who had been prescribed the drug within 90 days of the date of suicidal behaviour or ideation [i.e., thoughts]. Controls, also taken from the base population, were matched for taking the same antidepressant within 90 days before the case showed suicidal behaviour, age, and sex, but the controls had shown no suicidal behaviour.

In an editorial in the same journal (pp 379-81), Simon Wessely of the Institute of Psychiatry, London, wrote, "The results confirm that antidepressant prescription is indeed associated with suicidal behaviour, and strongly so."