Suicide and antidepressants

摘要

Antidepressants are mostly prescribed for depression and its complications. Foremost among these is suicide, but, despite these drugs having been available for over 35 years, no unequivocal evidence that they prevent suicide exists. Ironically, some antidepressants have been alleged to provoke self destructive behaviour, and patients sometimes kill themselves with the drugs prescribed to treat their depression. Antidepressant drugs are more effective than placebo in treating acute episodes of affective disorders, and they may help prevent relapses and recurrences of depression. Although they also decrease the score on the "suicide item" on the Hamilton rating scale for depression, this is not a valid measure of suicidal intent or a predictor of future self destruction. Suicide is rare, and small differences in suicide rates during treatment with different antidepressants could be due to chance or unsatisfactory matching between groups. Thus, saying that antidepressants prevent suicide could be more a statement of faith than of fact.