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Depression Therapy Reduces Suicide Attempts

Those who received it from their primary care doctor were least likely to attempt suicide, with levels in between for those who got individual psychotherapy from a therapist other than a psychiatrist. Thats not because seeing a psychiatrist makes you want to kill yourself, said Dr. Simon.

Rather, he suggested, these results reflect the fact that people with severe depression, who tend to be more suicidal, are more likely to be referred to psychiatrists, while those with milder depression stick with their primary doctors.

Our study indicates that theres nothing specific to antidepressant medications that would either make large populations of people with depression start trying to kill themselvesor protect them from suicidal thoughts, said Dr. Simon.

Instead, we think that, on average, starting any type of treatmentmedication, psychotherapy, or bothhelps most people of any age have fewer symptoms of depression, including thinking about suicide and attempting it. That said, he likened population-based studiesboth observational studies such as this one and randomized controlled trials of medicationsto circumstantial evidence about what happens to individual patients.

Like other psychiatrists, Dr. Simon has seen a few depressed patients start having suicidal thoughts while taking antidepressant medication despite never having thought about suicide before then. He hypothesizes that subgroups of people may be vulnerable to becoming more agitated or suicidal after taking these drugs. We hope to learn how to identify these people in advance, he said.

Dr. Simon published an earlier paper showing that the risk of suicide attempts decreased in the weeks after patients started taking antidepressant medication. His new study strengthens his earlier conclusion that for populations of people, even teens and young adults, suicide attempts tend to be rarer right after starting antidepressant medication than bef
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