Study Challenges Serotonin Drugs’ Link to Suicide

Prozac and similar mood-altering drugs do not seem to cause more suicides than older, less controversial antidepressants, doctors at Boston University say.

Based on about 160,000 doctors’ records from Britain in the 1990s, the researchers found that Prozac and Paxil -- both from a class of drugs called selective serotonin reuptake inhibitors -- caused no more suicidal tendencies than two antidepressants from a class known as tricyclics.

The study also found no difference in suicidal behavior between adults and teenagers -- another issue concerning antidepressants.

“We didn’t find an epidemic of teenage suicides in people being treated with antidepressants,” said Dr. James A. Kaye, senior epidemiologist for the Boston Collaborative Drug Surveillance Program at the Boston University School of Medicine and one of the study’s authors.

The study, published today in the Journal of the American Medical Assn., could help alleviate some concerns about the use of selective serotonin reuptake inhibitors.

But the study did find a significantly higher risk of suicide and suicidal thoughts for all the drugs during the first nine days of treatment.

Compared to patients who had been on the drugs for more than three months, those starting treatment were four times more likely to think about suicide and 38 times more likely to commit suicide.

“The time immediately after starting these drugs is the dangerous period,” Kaye said.

In March, the Food and Drug Administration directed drug makers to put warnings on 10 antidepressants, seven of which were selective serotonin reuptake inhibitors, to alert doctors and patients to possible suicidal tendencies.

One explanation for the group’s results is that all the drugs equally stimulate suicidal behavior. But Kaye said another factor could be that depressed people had a high risk of suicide because they were depressed.

The two tricyclic antidepressants in the study were amitriptyline and dothiepin.