The analysis revealed eight completed suicides, 134 suicide attempts and 378 instances of suicidal thoughts that did not lead to action. The odds ratio for suicidal behavior declined at a rate of 4.6 percent for every year of age, according to the study.
The report was criticized by Dr. John Geddes, a professor of epidemiological psychiatry at the University of Oxford in England and a co-author of an accompanying editorial in BMJ, who said it relied too much on data from trials sponsored by drug companies.
"In these trials, they compare a drug with a placebo," Geddes said. A placebo is an inactive substance. "These are hard trials to do so they exclude people who are very ill," he said. Because of this, he said, "they can't possibly observe how the drugs affect such people."
"One of the things that we need to be clear about is that we can't rely on placebo-control trials of new medications done by the industry," Geddes said. "They can't answer all the clinical questions. We need more active comparison trials which don't have placebo in them and larger trials aimed at antidepressants in clinical practice."
Geddes also criticized the report for lumping together all SSRIs. "Sometimes people are wary of saying that one drug is safer than another drug in the same class," he said.
But, he said, the studies indicate that suicide risk varies widely among SSRIs. "Sertraline is best in terms of tolerability," he said.
Studies cited in the report indicate that sertraline, the generic name for Zoloft, carries only half the risk for suicidal thoughts and behavior of some other SSRIs, Geddes said.
The U.S. Food and Drug Administration has more on antidepressants.
SOURCES: Marc Stone, M.D., senior medical reviewer, Center for
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