Well, that makes me feel validated! When I was 20, my psychiatrist doubled my dose of Celexa and it made me super suicidal. It ended up causing a psych hospitalization. But there were few people who believed the meds had anything to do with it because I was over 18... So while it's sad that it's a problem, I'm glad finally see something more definitive stating that the meds could have influenced me!

I have had untreated depression and anxiety many, many times and I am still here. However, when I took medications in my late twenties, I overdosed on purpose on two seperate occasions because I didn't care whether I lived or died. And then another time (Paxil), I truly wanted to die. That's proof enough for me.

Okay, let me try to wrap my mind around this:
"Many psychiatrists have criticized the warnings, saying they scare people away from effective treatment for depression, the leading cause of suicide."

So. Warning people (at least younger people) not to take something that doubles their risk of suicide somehow scares them away from "effective treatment" for the leading cause of suicide? Did I miss something here?

AP wrote "Many psychiatrists have criticized the warnings, saying they scare people away from effective treatment for depression, the leading cause of suicide."
AP writes as if there is only one kind of treatment for depression, the chemical kind.
As if suicide/depression is just bad brain chemicals easily fixed.
That is bad reporting.

What other medical illness causes suicide?

"The leading cause of suicide?" The leading cause of suicide is bad and/or impulsive decision making, antidepressant chemicals that can amplify feelings increase the patients odds of making a foolish decision.

If we are going with JUST chemicals for depression then why can't Psychiatry issue legal pot or other pleasurable chemicals for depression? (to induce laughter or induce munchies-hunger, we enjoy laughing and enjoy eating)

I wonder if, back in the day, the world is flat folks clung to their beliefs as tightly as the chemical imbalance folks do these days.

Why exactly would anyone take a drug that would double their risk of committing suicide? Again, I'm grateful that I was forced to stop taking psych meds 6 years ago because I couldn't afford them. I doubt even crack doubles your suicide risk.

These are precisely the conclusions that were made prior to the 2006 FDA advisory committee meeting and that led to expanding the black box warning from up to 18 to up to 25. And it really is complete b/s that SSRIs don't increase suicidality at all ages. As for having a "protective" effect I really know there's something fishy about the data that allowed that conclusion. I'd really like to learn a whole heck of a lot more about what kind of washout (withdrawal) protocols were followed in the trials on older people and what other confounding effects there might have been from tranquilizers and sedatives. I can almost guarantee that there was a lot of hokey pokey going on in the trials. Remember that antidepressants definitely reduce suicidality in people who are going through some kind of abrupt withdrawal. Also benzos and hypnotics can help to counter akathisia in people who are not already dependent on those classes of drugs and even sometimes if they are. Anyway I fail to see why this study is news. And as Philip points out many of the dubious "Kool-Aid" points have already been shot down many times before.

Psychiatrists have always been charlatans and snake oil merchants...

Whole profession is based on abuse and exploitation of the most vulnerable in society ... those who suffer from emotional and mental traumas...

This study is hogwash.

Dr. Martin Teicher's report back in 1990 of the patients who became VIOLENTLY suicidal on Prozac did not include anyone under 25. They were between the ages of 32 and 51.

I suppose Pharma and the APA are concerned because the Black Box for youth & suicidality has had an effect on the prescribing habits of doctors for their patients who over 25. Can't have anyone unmedicated no matter what their age.

I knew this study would happen eventually. Pharma was losing money and the APA was losing patients. Wonder how they "pulled this off"!

Great post and great comments. Here is my view: I suspect that there is a subset of people that get the impulsive agressiveness for homicidality or suicidality, while most people do not get this. The only problem is that the study designs are not proper for detecting the type of phenomenon I am suggesting.

We know that some people get really bothered by MSG / monosodium glutamate. Some people really get bothered by caffeine. Some people have allergies to antibiotics. There is a chemical called phenylthiocarbamide, and people differ genetically in whether they can or cannot taste this bitter substance - or is it actually bitter if you cannot taste it? This is a classic science-class experience - they hand out little pieces of paper with a bit of this stuff on it, and in class demonstrate that some people can and cannot taste it. It is obvious. The kids who can taste this immediately show disgust, and the kids who can't taste it start licking the paper gratuitously to gross out the tasters. You may have done this in science class yourself.

http://whozoo.org/mac/Music/taster.htm

So, there are a few exmaples that make it plain and simple that we differ physiologically in how our bodies get affected by different chemicals.

I believe in some people the serotonin drugs have some effect on the functioning of the neurotransmitter nitric oxide, as it works its job in the frontal lobe, whose job is to provide emotional control, oversight, planning, judgment, on-second-thought-maybe-I-should-not-type thinking. The antidepressants, for some, disrupt this neurotransmitter business, leading to a weakened ability to control impulses and thoughts. So, you get what some but not all people are reporting here and elsewhere.

In this recent report, the scientists have totally failed, despite two solid decades of info, to sniff out this clue. Here, they have again failed to investigate properly. They look for a significant level of incidence to answer a yes/no quesiton, but the phenomenon calls for a yes-for-some-no-for-others study design. This current report is like trying to determine whether humans find phenylthiocarbamide bitter, or whether humans get bothered by MSG in their Chinese food.

mvt,
Nice post. Thanks. One size does not fit all.

Homicide is totally unacceptable as a side-effect of a drug. Even if it only a sub-set of people who become homicidal on antidepressants, this issue must be addressed.

On www.SSRIstories.com there are 24 cases of people over 65 who committed a murder or murder-suicide while on SSRI or SNRI antidepressants.

In one case, that of an 81 year old man who murdered his wife, the jury found the man not guilty because of "involuntary intoxication" due to the Cymbalta! But we must think of that woman. Somehow, people like this wife who was killed - those people need to be protected.

No, homicide is defintely not allowable as a side-effect of a prescription drug. Japan has put warning labels for violence on their SSRI antidepressants.

I did write a post where I describe one of my suicide attempts while tapering of Effexor.
I was 46 years-old.
Kelley,
Please, be sure that drug-induce suicide ideation is real and I can assure you that real suicide ideation has nothing to do with drug-induce suicide ideation.
So do the review of the British Parliament "The Influence of Pharmaceutical Industry:

"“… SSRIs Prozac and Seroxat are the best-known examples of SSRI and related antidepressants, but others are widely used. The introduction of SSRIs led to a threefold increase in antidepressant prescriptions between 1990 and 2000. Prescriptions for antidepressants now match those of the benzodiazepine tranquillisers at their peak, 25 years ago. Almost from the outset, there was concern about two main problems with SSRIs. First, there was suspicion (initially centered on Prozac) that these drugs could induce suicidal and violent behaviour – infrequently, but independently of the suicidal thoughts that are linked to depression itself. There was also concern (centred on Seroxat) about a risk of dependence; some users found it impossible to stop taking SSRIs because of severe withdrawal symptoms. The MCA/CSM formally reviewed these problems on several occasions.”"

This is the link to the post I wrote about one of the two suicide attempts:

http://justana-justana.blogspot.com/2009/03/one-of-my-suicide-attempts-while.html

One day I will write about the second time.

Re: Anti-depressants can increase suicidality:

Philip:

At the risk of sounding like a broken record, I continue to wonder about the link between suicidality and suicide. As far as I know, there are no studies or research linking the two. As someone living with bipolar for more than 20 years, I can tell you that depression can produce suicidal thoughts, but it's a giant leap from that to taking your own life. So extrapolating from research that says anti-depressants increase suicidal thinking, that this means more people will kill themselves more often, is a stretch, at best.

Ironically, the supposed link between suicidality and suicide was one of the critical central issues we examined in the "Prozac Nation: Revisited" show on The Infinite Mind, a program which was shouted down in print by several bloggers who, like those at recent health care town hall meetings, don't care about having a discussion and ultimately are only interested in who can shout the loudest.

While there are those who think it's a given that thinking about suicide will lead someone to take their own life, as far as I know, it's not a given. Despite this, the FDA issued its black box warning for anti-depressants on the basis of suicidality, as well on the basis of tearful pleas from families, and pressure from Senator Grassley, who has distingiushed himself in recent days as someone who is willing to make up complete lies when it comes to health care (*), including his "Death Panel" comments this week. (* see Frank Rich in today's NY Times)

The whole thing reminds me of the debate about censoring sex and violence on TV. As they used to say, "if watching something violent makes people violent, why doesn't watching comedies make people funny?" The fact remains that there is a distinction between thought and action, Philip, which is apparently lost on the "Teabagger" contingent in mental health, who are apparently more concerned with making noise than considering the facts, or having a measured discussion. - BL

Woah up there. The odds ratio for those under 25 is 1.62 (unimpressive), but most notably the 95% confidence interval crosses 1.0.

This means that the "value of no difference" is within the confidence interval. So, in my mind, this does not clear up anything. It still seems possible that these medications have small impact on suicidal ideation, but this study cannot make that conclusion.

Suicidal ideation may or may not lead to suicide completion. But we can be quite sure suicide is preceded by some degree of thought of suicide. It buggers belief to think people just jump off a rooftop or shoot themselves without thought. They have to walk up those stairs, find the damned gun, etc.

I just don't get this splitting of hairs, as if somehow suicidal "ideation" is not much to worry about. The time to lock the barn door is BEFORE the horse leaves. We know it can ONLY get through an unlocked door. If you want to divert attention from this fact by focusing on how many horses need how many doors, don't waste my time or your breath (well, I guess it's fingers, since we're on line). I get really sick of this bogus line of avoidance.

PS: There's ample evidence that watching violence on telly increases violence amongst young children.

Some people posting here seem to be missing the point entirely...

It is a well known fact that in 4 out of 5 cases of people suffering from depression , the depression will lift on its own and run its course without the need for any medical intervention ... yet.. depression is marketed by drug companies as a "life threatening" illness ... Depression is probably just as much a "life threatening" illness as the common winter flu... millions of people suffer from depression all of their lives but never come close to suicide .. there is a risk of suicide of course.. but it is a small risk ... who wouldn't think of suicide when depression can cause such horrific despair?

Because of it's mysterious nature , depression and suicide are still widely misunderstood and thus easy to exploit...

It is obvious that SSRI med's induce suicidal ideation .. therefore they increase the chances of suicide even further then depression alone ...

The biggest marketing angle that these pharmaceutical companies in collusion with psychiatry took was the "exploitation of the danger of suicide with depression" .. yet as has been reported here and elsewhere for years, the drugs do little to safe guard against suicide , and can , in some cases increase it's likely hood ...

How anyone can think that these drugs are justified as is beyond my comprehension at this stage....

The whole SSRI saga is sublimely and dangerously beyond ridiculous...

Bill, comparing people who expressed legimate concern about the Infinite Mind Program to people at town hall meetings carrying swastika and threatening signs is outrageous.

Speaking of name calling, I have been referred to as a troll, mentally unstable, and an anti psychiatrist nut because I have expressed concern about the practices of psychiatry.

Anyway, as one who became suicidal at the age of 40 from Prozac, I can assure you that it was only because of supportive friends and great therapists that I didn't act on those impulses. Sherry is right, this is a hair splitting issue and detracts from the dangers that these drugs cause.

I agree with Sherry. Bill Lichtenstein has it backwards. No one is trying to say all suicidal ideation leads to suicide. But I do think it's a stretch to think that suicide is not preceded by some suicidal ideation so if we increase suicidal ideation we're going to get some extra suicides. This really is not rocket science. The question is not whether suicidal ideation definitely leads to suicide but whether suicide is preceded by suicidal ideation -- I'm pretty darn sure it is. Increasing suicidal ideation is not something we want our meds to be doing. And increasing homicidal ideation is even worse which of course these meds do as well.

Bill wrote:

"At the risk of sounding like a broken record, I continue to wonder about the link between suicidality and suicide. As far as I know, there are no studies or research linking the two. As someone living with bipolar for more than 20 years, I can tell you that depression can produce suicidal thoughts, but it's a giant leap from that to taking your own life."

Um, still why would anyone pay money (and have their health damaged and civil rights and access to health care diminished) to take a drug that makes him or her want to kill his or her self, even if he or she resists the urge?

Are you suggesting that somehow being suicidal diminishes your likelihood of committing suicide? If so, well, that seems pretty unlikely.

Bill,

Wow! Now you scared me.
If you take a look at me previous comment I explained my suicidal ideation and put a link to the post I wrote about one of my suicide attempts caused by Effexor.
There is also the review of the British Parliament:

"(initially centered on Prozac) that these drugs could induce suicidal and violent behaviour – infrequently, but independently of the suicidal thoughts that are linked to depression itself."

You have visited my blot claiming that:

"I am writing as executive producer of The Infinite Mind regarding your posting on the show's audience size.

The Infinite Mind was not a mental health show. It focused on the art and science of the mind, mental wellness, neuroscience and the mind body connection.

Most of our 200+ programs over 10 years had little to do with mental health, with show topics including Satisfaction; Hearing; Body Clocks; Altruism; Perfect Pitch; Genius; Animal Companions; Multitasking; Writers' Block; and Weather and the Mind, among many others."

Now I'm informed that you are much more than a Producer. You are bipolar - bipolar 1 or 2? - and your view on drug-suicide ideation:

"The whole thing reminds me of the debate about censoring sex and violence on TV.

" "The fact remains that there is a distinction between thought and action,

I wonder what was told to the audience during the few shows about mental health.

Yes, you are fight. We are all anecdotal evidence that the FDA and others don't want to study or conceal data related to this ailments.

Homicide is a totally unacceptable side effect of ANY MEDICATION ...

I could not agree more...