Antidepressants and Suicide: Biologic Marker?
Once in a while a single research study really advances our field. I think it just happened again.
Psychiatry is making major advances in terms of understanding the genetic, molecular, and brain-structure basis of some of the illness is that we treat. Frankly, this is the best field and medicine to be in right now -- at least in terms of watching good science happen. (It might be one of the worst in terms of how badly our current health care system is treating people with mental illnesses).
In any case, here is an interesting new result. The study was made possible as part of a huge study of depression in the United States (funded by our taxpayer dollars, one of the best uses I can think of -- in some ways this was like the Hubble telescope of mood disorder research).
The bottom line: even though many psychiatrists have criticized the FDA for placing a warning label on antidepressants about their potential for inducing suicidal thinking; and even though some evidence has emerged suggesting that the warning may have increased suicide rates by decreasing antidepressant use (this is still quite controversial); it would be nice to know if antidepressants really cause suicidality at all, even if rarely. This new study provides further evidence that indeed such a phenomenon occurs, as a result of the antidepressants.
But the study goes one step further: it identifies two genes which seemed to be associated with this new onset of suicidal thinking when an antidepressant is used (interestingly, the genes are not associated with suicidal thinking itself, which none of the patients in the study had before they received the antidepressant).
For more, see my Antidepressants and Suicide webpage.Dr. Phelps
posted by PsychEducation | This post's link
2 Comments:
I was treated with anti-depressants (first Prozac, then Wellbutrin, finally Lexapro years later).
During the first 2 months I took Prozac, I saw significant improvement in my mood, but what I didn't realize until recently was that they were actually gradually making me more and more hypomanic.
During 8 months of treatment for major depression in 2001(my BPII was JUST diagnosed about 2 weeks ago), I attempted suicide no less than 4 times and had suicidal thoughts almost constantly.
Last year I went into a walk in clinic (no insurance means almost no health care) extremely hypomanic complaining of severe stress.
I was treated as a 'drug seeker' and given Lexapro, which within 5 days caused complete insomnia (didn't sleep at ALL for 4 days), suicidal and so manic that I felt I wanted to crawl out of my skin.
Last November yet another doctor (I use that term loosely), prescribed another antidepressant even though my intake form said, SSRI'S MAKE ME SUICIDAL!!!. Luckily I asked the pharmacist what the drug was and didn't fill it.
ABSOLUTELY anyone being prescribed an AD should be screened for BP beforehand, it's simply good medicine.
I went into the last two doctors I mentioned in an obvious hypomanical state & instead of referring me to a phychiatrist or giving me something to stabize my hypomania, they just handed me AD's as if they were candy.
Thank goodness I have finally found a therapist (after my last suicide attempt), who after 10 minutes asked me if anyone had ever suggested that I might be BPII.
I bought Dr. Phelp's book and my picture should be on the cover!!
So, my vote is YES, AD's can and DO cause suicidal thoughts and/or actions in BP's.
I, too, was misdiagnosed with depression and anxiety. After my suicide attempt and hospitalization, I was diagnosed correctly with BP. I have a wonderful doctor and therapist now.I know a combination of AD and stress caused my suicide attempt.
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