New study: antidepressants significantly raise the risk of suicide in the treatment of depression for adults

Adults who start treatment with antidepressants for depression are 2.5 times more likely to attempt suicide when compared to placebo, according to new research published today in the journal Psychotherapy and Psychosomatics.

The study found that approximately 1 in every 200 people who start treatment will attempt suicide due to the pharmacologic effects of the drug. This number is significant given around 7.4 million people were prescribed antidepressants in England alone last year, and given international estimates which suggest around 1 in 20 suicide attempts will end in death.

The study, ‘Newer-generation antidepressants and suicide risk in randomized controlled trials: A re-analysis of the FDA database’, reanalyses the safety summaries submitted to the FDA (the US drug regulator) for new generation antidepressants (SSRI, SNRI and atypical serotonergic-noradrenergic antidepressants like mirtazapine). The study was led by Dr Michael P. Hengartner, a senior research fellow at the Zurich University of Applied Sciences and member of the Council for Evidence-based Psychiatry (CEP), and Dr Martin Plöderl, senior researcher at Paracelsus Medical University, Salzburg.

Hengartner and Plöderl examined all suicides and suicide attempts recorded in the safety summaries of all antidepressant trials submitted to the US drug regulator FDA between 1987 and 2013 for marketing authorisation of new antidepressant drugs for the treatment of adult major depression. In these randomised controlled clinical trials, the rate of suicide was about 3 times higher in those taking antidepressants compared to placebo, and the rate of non-fatal suicide attempts and suicides combined was about 2.5 times higher in those taking antidepressant compared to placebo.

Based on this, the study estimates the absolute risk increase in the rate of both fatal and non-fatal suicide attempts for antidepressants vs placebo to be about 0.5%, which is statistically a highly significant effect. While this study does not attempt to identify the precise cause, other studies have suggested that rare adverse drug reactions such as akathisia or extreme agitation, as well as severe withdrawal reactions upon stopping the drug, may increase the suicide risk.

Earlier analysis of this data did not reveal the increased risk because the method used was incorrect. Previously, calculations were based on ‘person exposure years’ (PEY) rather than the number of patients receiving treatment. PEY is not the correct method here (especially when treatment duration with drug and placebo differ) because it assumes that the hazards (i.e. the suicide risk) remain constant over time, whereas the evidence shows that the highest suicide risk occurs in the first four weeks after the start of treatment, as well as shortly after the drug has been stopped. For this reason both the FDA and MHRA require that the number of patients receiving treatment should be used for these calculations rather than PEY.

Other opinion leaders and some patients have argued that antidepressants reduce the overall suicide risk, due to their mood-altering effects. However recent studies across various countries show that, on average, increases in antidepressant prescriptions over time correlate with slightly increased suicide rates. These studies note however that this association does not imply causation.

Commenting on the findings, Dr Hengartner says, ’Our study signals a rare but serious risk that needs to be brought to the attention of healthcare practitioners, particularly when starting or stopping antidepressants. We suggest that this risk should be taken into account when doctors discuss the harms and benefits of SSRI and other newer-generation antidepressants with adult patients. It is also important that people should not stop antidepressants suddenly, and that any reduction should be discussed first with the prescriber. ’

Dr James Davies, co-founder of CEP, says, ‘It is known that antidepressants increase the risk of suicide among young people and adolescents, and for this reason their use is restricted among these patient groups. However this research indicates that suicide risks also occur for some adults. This new evidence should now be reviewed by regulators, reflected in clinical guidelines and brought up in conversations between doctors and their patients.’

The study can be viewed (open access) at the following link: https://www.karger.com/Article/Pdf/501215

29 Responses to New study: antidepressants significantly raise the risk of suicide in the treatment of depression for adults

  1. kiwi 25/06/2019 at 9:27 am #

    Validation for what we survivors already knew. Its a miracle I am still alive after the withdrawal trauma I had to endure. I know that I am not alone. Furthermore like myself I know that most people rather than be informed of withdrawal trauma were simply given diagnonsense when seeking answers.
    I hope the truth continues to come out.

    • Beverley Susan Melampy 13/01/2021 at 12:53 pm #

      I can’t believe someone knows the withdrawal from this trash as well as I. What’s more surprising, we share the same nickname. #beverleysusanmelampy @Facebook….see what other things we may have in common. I have ‘documented’ enough ‘government records’ to cause an immediate investigation of VA Mental Health’s PTSD drug ‘research that sent myself and God knows how many veterans to SUICIDE HELL for 30 years. They are the ones who approve these drugs and tell us they are safe for the rest of the country to use.

    • Manawahine 17/02/2021 at 7:11 pm #

      I just survived six months of increasing suicidality and an attempt, and so many nights of trying to keep myself from making an attempt. The doctors continued to increase my dosage of sertraline in response to my complaints about suicidality. It wasn’t until I ended up in a residential facility that I began to taper off the sertraline and the suicidality rapidly decreased. I’m still trying to understand how exactly these drugs hijack one’s thoughts. It’s terrifying. But I’m so grateful to hear these snippets of other people’s stories and know that I’m not alone.

  2. Barry Haslam. 25/06/2019 at 7:15 pm #

    It is validation as kiwi above says.

    But for me as a victim of prescribed benzodiazepines and as a result left permanently disabled. The SSRI prescribing debacle has been allowed to develope virtually unchecked because SSRIs have been perceived as non dependence / addiction forming and therefore less dangerous than benzodiazepines but in practice are creating exactly the same dangers and damage to public health.

    Successive governments over the last 50 years have constantly kicked the benzo can further down the road and ran away from their responsiblities. By doing so, they have allowed the SSRI prescribed epidemic to hugely spread and for immeasurable harm to be done to innocent patients and their families.

    • N Jones 26/06/2019 at 4:54 pm #

      Opioids as well….it’s an utter disgrace…..and how long has the Ashton Manual been available?

      I dumped myself into opioid (fentanyl) withdrawal due to tapering too fast…I had no idea I may break my brain so badly. My pain Consultant or GP didn’t even discuss how to taper for me and I was looking out for physical symptoms. And it’s been 10 months and there is no pathway to help…even for opioids which you might assume would be the most understood of drugs…so what hope is there for the others?

      It was just so unnecessary is the frustration, I just needed the support and information and I’d be doing fine, even if I had the odd rocky day. The medics involved are lucky that the coroner isn’t talking to them quite frankly.

      This is entirely patient led now…and I hope we are the last of the affected….

  3. N Jones 26/06/2019 at 4:49 pm #

    The lack of medical understanding and responsibility regarding the effects of withdrawal from ALL dependence forming drugs is one of the biggest medical calamities ever….

    Ignorance might have been an excuse previously, now there is no excuse and every patient who does not give informed consent or is allowed to discontinue or taper their medication without any assistance or advice is actually medical negligence at best, murder at worst. No more excuses.

  4. survivor 28/06/2019 at 11:00 pm #

    As a person over 50 who became suicidal after taking antidepressants, and then being told I needed a higher dose because antidepressants couldn’t be the cause, I welcome these findings.

    The whole time I was on them, I had a simply overwhelming desire to kill myself, and very nearly succeeded. And guess what?…As an involuntary patient hey told me I need MORE antidepressants…but they needed to be combined with antipsychotics because I was so mentally ill. I was forced to take them and it was pure hell.

    Despite my drug induced fog, I managed to do some research, escape psychiatry and gradually wean off their drugs…a horrible process. I stopped being suicidal.

    A few years later when I was down my doc suggested an antidepressant and I decided to give it another go. Big mistake! My overwhelming desire to kill myself returned, but this time I was very quick to stop the meds. Guess what? No more overwhelming desire to kill myself.

    Doc said it likely wasn’t the meds because there was no evidence of this in the research, but, thankfully, didn’t try and coerce me to stay on them.

    This research needs to be widely disseminated and fast!

  5. kiwi 28/06/2019 at 11:25 pm #

    Sometimes I kinda wish that ssris were manufactured by Russian companies, if they were then these sort of news findings would cause such a public outcry the chemicals would be banned.
    We all know what kind of response happens when Russia (allegedly) poisons just one or two people in Britain.
    Yet the UK poisons and harms millions of their own kind and hardly a voice is raised.

    I would have thought that a post like this from CEP would have triggered a flood of outrage and postings on this site and elsewhere, yet all we get is Barry and kiwi saying thanks for the validating information.

    I just don’t understand it. This is a national and worldwide epidemic. A tragedy of epic proportions involving tens of millions of people!
    Either millions of people are not ‘getting it’ or they just don’t care!

    Why is there no public outcry over this news?

    • Rosemary Knowles 27/07/2019 at 11:37 am #

      Kiwi – I hear your outrage over these conspiratoriallly supppressed facts about suicides caused by antidepressants. It appalls me too, but hopefully once we get Brexit done and a new Health Minister in office, with the APPG review findings reported – things must change. Meanwhile, people like you and me who do care have to keep battling on, despite our letters never getting answers from the powers that be. It is exhausting!

  6. H.JJ 29/06/2019 at 10:30 am #

    This is not surprise for me at all. I tapered off SSRIs after long term use and withdrawal triggered a nightmare. Doctor insisted I was not suffering from withdrawal after 2 months from stopping and prescribed more drugs for “depression”. It was new kind of depression because I had never had that kind of symptoms before. Insomnia, nightmares, confusion, agitation, inner restlessness, anxiety, extreme fatigue, brain fog, weird brain zaps and so on…

    I got no information of the horrible nature what SSRI wd can have or I got no information how to taper off slowly and carefully so I tapered during 3,5 months that was too fast considering i had used antidepressants for so long. One reason this drugs cause suicidal thoughts is that many doctors dont understand withdrawal at all and dont have a clue what problems these drugs cause. They see always pills as a treatment and a solution, even if pills are the cause of symptoms. Thats scary.

    I was prescribed benzos and other drugs to treat my insomnia and my “depression”. SSRIs were tried to reinstate with no good results.

    New drugs made things only worse. I became suddenly suicidal and got inner restlessness to the point it was akathisia that I know now can be the trigger that causes suicidal thoughts in people who use psych drugs. I know my suicidal thoughts came from these so called meds.

    Withdrawal itself and wd symptoms (more like damage) caused trauma and suicidal thoughts.

    I have had years of really dark thoughts after this experience I went through with these drugs. I have spent a long time trying to taper drugs i was prescribed. Benzos have made me disabled, made my symptoms worse that were triggered during SSRI withdrawal and benzo withdrawal has been even worse.
    I spend daily battling with many weird symptoms and I feel like no one believes me when I try to say what I have go through. Its tough.

    What is great is that symptoms have got easier after tapering of new drugs when I dont suffer from side effects anymore.

  7. Dawn 06/07/2019 at 2:57 pm #

    Could it be that everyone is either drugged to complacency-flat effect or trying to survive protracted psychiatric medication withdrawl syndrome? ! I think so.

  8. Karl 31/07/2019 at 1:11 am #

    I hear you I’ve been off an ssri for 7 years now and have never been the same since was given it for anxiety and was told to take it for six months reassured it was totally safe when I told my GP in 1998 as a young twenty year old that I didn’t want to take tablets. I was told it was safe and reassured to try it as a young vunerable twenty year old I believed my doctor biggest mistake off my life. Was stuck on it 13 years every time I tried to come off was told it was my anxiety returning it was all lies I done things on this tablet totally out off character which still have repercussions today when I eventually stopped I entered a physical and mental hell you could couldnt comprehend unless you’ve been there this lasted years constantly and I mean years not a couple the worst went on for at least six years how I’m alive I don’t know. I’m slightly better now but never been the same I don’t believe it’s withdrawal after six months but damage which is unmasked with stopping the drug. The symptoms are so bad it feels like your being mentally and physically tortured for years on end I can see how people easily take there lives due to these effects. I never had any off this prior to taking seroxat I had anxiety which was a picnic compared with what happened when I stopped. For anyone who thinks I’m exaggerating believe me these drugs can take you to a place you wouldn’t believe existed and the worse thing is when you ask for help it’s all denied and your left MAIMED no wonder people commit suicide. It took me at least six years to feel any respite and I’m not the same person and don’t think I ever will be I had anxiety was fit as a fiddle never was depressed these tablets destroyed me physically and mentally I don’t know how the medical establishment has got away with it and then to be denied is the icing on the cake. These pills cause neurological and nervous system damage be warned.
    Atleast some awareness is starting to come to light but doctors saying withdrawal can last months now rather than a couple off week like they said before is still far from the truth. Some people might be lucky but mine has lasted years and so have many others

    • Patrick 25/11/2019 at 2:57 pm #

      Hi Karl and everyone who will read

      I’m 43. I was on antidepressants for 17 years. Effexor xr more specifically. 300 MG for lime 5 years and then 150 MG for the last 10. Something like that.

      I have been using cbd oil for about 3 months and I quitt my 150mg, not cold turkey but went down for about 2 months until I had just a bottom of capsule and then stopped. It’s been 3 weeks now. How? Well, hemp CBD oil has been pretty incredible. it really helped stabilise my mood and many other benefits that are physical. I do have symptoms, some weird, like wanting to eat shrimps and meat and such. Also a bit of the eye zapping (when you close your eyes and go from side to side it feels lime an electric impulse). All in all been going to work and been doing my job as a father of 3 with surprising ease. My memory has been better also. I can retain and recall a lot more since I stopped effexor.

      I’m on the site today because I woke up with suicidal thoughts. What a crappy feeling. I know it’s all part if dealing with the withdrawal from the drug, but man it is the worst. I have 3 wonderful kids and I could not get them ready for school this morning. My wife had to take over. I’m missing work today; I took an extra dose of cbd by capsule and it seems to have made a big difference.

      Typical is 25 to 50 mg daily but I have been taking about 80 to 90 mg daily, morning noon and evening as a tincture under the tongue since I have stopped effexor. The thoughts are gone now. Still feel a bit of dread but not like it was about an hour ago. I now depend on cbd oil for everything. I also exercise 3 times weekly. I have been for years. It was never a cure in itself for the blues and restore my mental health, but does send a good dose of endorphins in the bloodstream which helps.

      And I’m so tired of diarrhea! It’s been like 2 months or so. I assume it’s normal since you are kinda shocking your system when you stop a dependency causing drug. A spade is a spade man. This is what this is…an addiction.

      Cheers

    • Terry 10/12/2019 at 11:21 am #

      I like you Carl have had the same thing happen to me my life has been destroyed by these so called harmless drugs I was told they were safe and I have battled for the last 7 years in hell everyday I think of suicide to get some relief from this suffering like you the medical profession don’t believe me and there is no help I couldn’t wish this daily suffering on another human being truly I couldn’t . I am currently 3 years off melds and still so sick with so many physical symptoms I can’t tolerate any supplements as my nervous system is destroyed I live with a dark depression every day and the suicidel thoughts never leave me I never had any of this before medications I have lost all my friends and love ones I have had to give up everything dear to me my job my hobbies as there is no pleasure in my life just suffering my life has been stolen from me like so many others and the worrying thing is I’m getting worse with time not better someone should be held accountable for this harm and damage

  9. Rosemary Knowles 05/08/2019 at 12:30 pm #

    To everyone who has suffered or is still suffering from antidepressants/benzos and/or other psychoactive pills, – may I recommend you write snail-mail to Prof. Wendy Burn, President of the Royal College of Psychiatrists, 111 Hagley Road, Birmingham B16.8LB.
    Give an account of your experience as graphically as possible, and ask when she will put a stop to this crime against humanity. Tell her that if she does not reply you will pass the letter on to the Health Secretary, Matt Hancock and ask him to get her removed from her job, and then to look into the Regulator, MHRA to ensure they do not have links to pharmaceutical companies who make and promote with corrupt practices these deadly medicines. Demand that all suicides be recorded with any links to ADs. I did that – and then the Cepuk.org post of 30th May re: changes by RCPsych was published, just 2 weeks after the Health Secretary would have received my letters. Just try it. The weight of numbers might make them take notice. The NHS is being reformed – now is the time to pressurise it to stop these harmful drugs.

  10. Paula 25/11/2019 at 5:50 pm #

    My daughter was 18 she’d been on fluoxetine for four weeks when she hanged herself in her bedroom . Her twin sister found her . Nine months before her death she was prescribed fluoxetine for depression that was diagnosed by 9 questions read from a computer. Four weeks later she cut both her wrists so badly she needed an operation . My daughter should and would be alive today if she wasn’t put on those mind altering poisonous drugs.

  11. Paula 25/11/2019 at 8:27 pm #

    My daughter was 18 she’d been on fluoxetine for four weeks when she hanged herself in her bedroom . Her twin sister found her . Nine months before her death she was prescribed fluoxetine for depression that was diagnosed by 9 questions read from a computer. Four weeks later she cut both her wrists so badly she needed an operation . My daughter should and would be alive today if she wasn’t put back on those mind altering poisonous drugs again after she was off them .

  12. Shelley Price 28/11/2019 at 12:23 am #

    My partner died this year from suicide, a very violent way, he a d I were together for 20 years he never ever shown this behaviour, he was on valium for most of the time , doctors took him off , guess wot highly addicted, abit late they had freely dished them out to him from age 16 to 48, then cut him off mmm, a d then 3 months later he became very depressed anxiety through the roof went bk to go no u can only have a antidepressants, he in the end hoped bc they said it will help with anxiety, didn’t work , A n E 3 times frm suicide attempt after taking them , sent home with beta blockers, yea rit, 2 days later he threw himself in front of a bus, a d valium is addictive, my god they killed him , these a antidepressants I know, I lived with him 20 years toxicology report negative, at inquest suicide, why ? I believe he told me the tablets drove him to his death .

  13. Sad Grandfather 30/11/2019 at 9:32 pm #

    My 21 year old granddaughter committed suicide on October 26th. Her suicide note specifically stated SSRI withdrawal pain and hopelessness as the cause. Her note: “SSRIS MURDERED ME [name omitted]”. Please stop murdering children and young adults with brain altering SSRIS. A sad, angry grandfather who has lost some one he dearly loved.

  14. Stephen T. McCrea 07/02/2020 at 10:54 pm #

    How many studies does it take to convince the public that the SSRI mythology is massively distorted? Peter Breggin reported on this in 1993! Over 25 years ago. And yet the psych profession is still pretending it’s because “depressed people are more likely to commit suicide,” even though suicidal people are screened out of the studies?

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