Posted by SLS on July 20, 2005, at 18:36:44
In reply to Re: Bad (but expected) news about ADs, posted by linkadge on July 20, 2005, at 16:38:46
Hi Linkadge.
> I don't think that study shows anything.
>
> Suicide rates go up and down like a yo-yo.As was previous mentioned, I think sociological variables play a significant role in the rates of mental illness (not necessarily suicide) in a population. As the stress in a population increases, as seems to have happened in western society in general, I think the rate of depression increases.
> Plus, if what you are saying is true, then this study has no merrit as well (since as you are proposing that we did not record suicides too well in the past)No. What I am proposing is that mental illness and suicides are more apt to be reported now than they were 100 years ago. Thus, if rates have suicide have decreased, or even stabilized within the milieu of increased reporting, then the true rate of suicidal has actually decreased with the advent of antidepressants.
> The link between antidepressants and suicidal behavior was so strong, that England basically banned their use in children.
This is unfortunate. Antidepressants have also decreased the rate of suicide in adolescents. I do feel that psychotherapy should be the first line therapy in pediatric depression unless severe psychomotor retardation is present. Pediatric bipolar disorder presents a particularly difficult quandry. If not treated biologically, it will only get worse.
Adolescent antidepressant-induced suicides could be prevented by educating the patient that they could possibly feel worse, and that this should be reported promptly. They should also be monitored particularly closely with weekly visits to the doctor. I don't like the idea of serving the developing brain a meal of Prozac any more than you do. We don't yet know what the consequences are.
> Are you saying that they based their decision on nonsence ?
I think they based their decision as much on political pressure and panic as they did by a naturalistic study of the phenomenon.
> Canadian suicide rates increased
> http://fathersforlife.org/health/cansuic.htmPerhaps the socialized medical system of Canada doesn't lend itself to prompt and robust intervention in cases of depression. This has been the impression I get from the posters here, particularly you.
> US suicide rates decreased (although very insignificantly)
According to the literature I encounter on the Net, I invariably come across statements to the contrary; that the rates of suicide has decreased, particularly since the advent of the SSRIs and the increase in the percentage of people seeking treatment. It is illogical to conclude otherwise. Even if we just consider the impact of lithium, we both agree that it prevents suicide at a significant rate. How could the rate not be reduced significantly?
It is my guess that the rates of depression has increased over the last few decades as the stresses of societal day to day living has increased. However, it is also my guess that the percentage of these people committing suicide while taking antidepressants has decreased considerably. In other words, these drugs work. Prospective studies designed to observe probands longitudinally is a much better way to assess this hypothesis than using gross population statistics.
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1: Arch Suicide Res. 2005;9(3):279-300. Related Articles, Links
Suicide in 406 mood-disorder patients with and without long-term medication: a 40 to 44 years' follow-up.Angst J, Angst F, Gerber-Werder R, Gamma A.
There is no data on the variation in the suicide risk over lifetime and on the suicide-preventive effect of the long-term treatment of mood-disorder patients with antidepressants and neuroleptics. Our research focused on 186 unipolar (D), 60 bipolar II (Dm), 130 nuclear bipolar I (MD), and 30 preponderantly manic patients (M/Md); that were followed-up from 1963 to 2003. By 2003, 45 (11.1%) of the 406 patients had committed suicide. Suicide rates were highest among D patients (Standardized Mortality Ratio, SMR = 26.4), MD (SMR = 13.6), Dm (SMR = 10.6) and lowest among M/Md patients (SMR = 4.7). Prospectively, the suicide rate decreased over the 44 years' follow-up; Lithium, neuroleptics and antidepressants reduced suicides significantly. Long-term treatment also reduced overall mortality, and combined treatments proved more effective than mono-therapy.
PMID: 16020171 [PubMed - in process]
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- Scott
poster:SLS
thread:530123
URL: http://www.dr-bob.org/babble/20050718/msgs/530752.html