Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by ed_uk on December 29, 2006, at 15:43:15
From prescriber.org.uk ................
Suicidal Ideation and SSRIs
December 29, 2006 on 1:11 pm
The journal of Psychotherapy and Psycosomatics has published two articles examining the association between suicidal ideation and prescription of selective serotonin reuptake inhibitors (SSRIs). PharmaTimes has also reported the publication of these articles.
The first article is a secondary analysis of a 12-week open study of fluoxetine (Prozac). Analysis of the data found that 14.3% of individuals in the study who had no suicidal ideation at baseline reported it at least once during the course of the study.
The second article is an evaluation of the evidence supporting treatment of children and adolescents with SSRIs. The author found 10 studies comprising 2,046 patients who were treated with fluoxetine, paroxetine, sertraline or citalopram. An additional 6 studies were also found that were not published due to lack of efficacy or problematic side effects. The analysis found no data supporting the use of SSRIs, except for fluoxetine. The author concluded that SSRIs are second line for severe and resistant forms of adolescent depression.
Action: When prescribing SSRIs for the first time an assessment of suicide risk should undertaken and repeated periodically. Guidelines are available from the National Institute for Health and Clinical Excellence for depression in Adults and Children and Young People.
Posted by Phillipa on December 29, 2006, at 17:57:37
In reply to A little more info-old topic-SSRIs and suicidal id, posted by ed_uk on December 29, 2006, at 15:43:15
Thanks Ed what about their effectiveness in adults any changes? Love PJo
Posted by blueberry1 on December 29, 2006, at 17:57:54
In reply to A little more info-old topic-SSRIs and suicidal id, posted by ed_uk on December 29, 2006, at 15:43:15
If the whole theory of chemical imbalance is true, then it could be possible for an ssri to make the imbalance even worse. Example, someone who's depression is related to dopamine and not serotonin. My hunch is that is more people than is recognized.
The side effects can be so tremendously burdening to someone who is already severely depressed that it pushes them over the edge. Insomnia, nausea, dizziness, sexual dysfunction, sedation, fatigue...I mean, can someone severely depressed handle all that stuff? It does not seem fair to me that the very people who are the weakest and the most vulnerable are the same ones expected to somehow endure feeling even worse during startup with no real guarantee it is going to get any better, and that somehow these severely crippled weakened depressed people have to find the capacity to endure weeks of waiting. Strange. I can understand asking a healthy person to endure antidepressant startup and waiting. They are strong enough to handle it. But someone is gravely ill?
I am so very glad that some people find ssris fantastic. And I am so glad that some people find side effects to be very minimal. Some people even start feeling a lot better in just days. That is very cool. But I can relate to those people who find themselves in worse condition on antidepressants than where they started. It has happened to me plenty of times.
I've been to the hospital 3 times for suicidal ideation. In every case it was within 4 days to 4 weeks of starting a new antidepressant.
Posted by stargazer on December 29, 2006, at 18:34:27
In reply to Re: A little more info-old topic-SSRIs and suicidal id, posted by blueberry1 on December 29, 2006, at 17:57:54
How may people died during SSRI trials because they were told that SI meant the depression was getting worse and to continue the AD they were on and to increase the dose?
This happened to me with either Zoloft or Effexor and my doctor kept telling me to hang in there and keep taking the med, but I said to myself, something did not feel right. I said I either quit the med or I will kill myself and I stopped the drug and the SI went away.
Coincidental, I don't think so but I essentially had to go against my pdoc's advice trusting my gut instinct that it was the med and I know to this day, it would have made me kill myself.
I'm sure we will never know the number of people who listened to their pdoc, believing that the AD would work and ended up killing themselves.
No way of knowing how many but treatment with many drugs can be worse than the disease itself. Chemo drugs can do the same thing.
Stargazer
Posted by linkadge on December 29, 2006, at 19:23:04
In reply to Re: A little more info-old topic-SSRIs and suicidal id, posted by stargazer on December 29, 2006, at 18:34:27
The closest I ever came was withing 2 days of starting effexor. It gave me this frigteningly sick feeling, like I was going crazy. I made it into my fathers guns and thats as far as I got.
It made me feel like I *needed* to know all the answers to my problems right then and there. It made all my problems seem so much more impending.
I knew the drug was making me feel off, but the drug created this terrable sense of urgency, like it was "pusing" me. It put all of my anxieties right in my face. I never knew how it was marketed as a anxiolytic but hey.
Linkadge
Posted by bassman on December 29, 2006, at 19:34:22
In reply to Re: A little more info-old topic-SSRIs and suicidal id, posted by blueberry1 on December 29, 2006, at 17:57:54
My feeling EXACTLY. I think anyone, independent of their age, should be monitored closely when taking psychoactive meds for the reasons you stated-until they stabilize. Somehow people are amazed that you take a person that is very, very sick and make them feel worse and they think about suicide. Duh.
Posted by Phillipa on December 29, 2006, at 19:59:08
In reply to Re: A little more info-old topic-SSRIs and suicidal id » blueberry1, posted by bassman on December 29, 2006, at 19:34:22
I couldn't agree with you all more. As I have quit many meds as they made me feel so horrible. My gut said quit and I did. I've been chastized even here for not sticking with a med. And now it's ll years with no relief. Love Phillipa ps maybe I'm a martyr or sadistic to myself but what do I do? And the hospitals won't monitor you if you're not actively suicidal or homicidal no dice.
Posted by Cecilia on December 29, 2006, at 23:22:48
In reply to A little more info-old topic-SSRIs and suicidal id, posted by ed_uk on December 29, 2006, at 15:43:15
I don't get it. I just find it hard to believe that ANYONE who is depressed enough to agree to take an AD would have no suicidal ideation at baseline. Yes, the AD's can make it worse, either because of side effects, worsened "chemical imbalance" or increased discouragement because the drugs aren't helping, but I suspect most depressed people have "suicidal ideation", though they may not admit it because they're afraid they might get put in a hospital. Cecilia
Posted by notfred on December 30, 2006, at 21:48:30
In reply to Re: A little more info-old topic-SSRIs and suicidal id, posted by Cecilia on December 29, 2006, at 23:22:48
People with depression and SI were screened out; not selected for this study.
Given that SI is common with depression I do not see that this study proves anything. Perhaps there were controls but otherwise there is no proof of one thing causing another.
It has always been my impression this effect has been known about for some time. It is becoming an issue now as more people are taking AD's.
This is the end of the thread.
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