Anti-depressants and suicidal behavior
This pisses me off: FDA may expand antidepressant warning
Some people (<14 in 1,000), mostly children and adolescents, with depression kill themselves within the first few weeks of treatment with an anti-depressant. Vastly more kill themselves without treatment at all, or with psychotherapy. Suicide is not a side-effect of the drug, it's a side-effect of severe depression coupled with having the energy to do it.
They find that the 'suicide on antidepressants' thing happens more with children and adolescents, and that doesn't surprise me at all. Being naturally more impulsive and having less of a concept of time and permanency, it is not the least bit surprising that they are the ones who go through with it. They're still depressed and have suicidal thoughts, but now under treatment still feel mostly depressed but are starting to get marginally better and now have enough energy to follow through -- and don't yet have the ability to really think through the ramifications of that decision with the benefits of maturity, experience, and an adult brain.
Adding the black box warning will scare off patients (and prescribing doctors) who could otherwise be helped because they'll hear "this drug makes people kill themselves." In reality, we're just seeing a phenomenon we've known about for a long time - that severely depressed people are most likely to commit suicide when they enter the upswing out of it - but because that upswing is pharmacologically-induced, now it's a side-effect. Dammit.
Some people (<14 in 1,000), mostly children and adolescents, with depression kill themselves within the first few weeks of treatment with an anti-depressant. Vastly more kill themselves without treatment at all, or with psychotherapy. Suicide is not a side-effect of the drug, it's a side-effect of severe depression coupled with having the energy to do it.
They find that the 'suicide on antidepressants' thing happens more with children and adolescents, and that doesn't surprise me at all. Being naturally more impulsive and having less of a concept of time and permanency, it is not the least bit surprising that they are the ones who go through with it. They're still depressed and have suicidal thoughts, but now under treatment still feel mostly depressed but are starting to get marginally better and now have enough energy to follow through -- and don't yet have the ability to really think through the ramifications of that decision with the benefits of maturity, experience, and an adult brain.
Adding the black box warning will scare off patients (and prescribing doctors) who could otherwise be helped because they'll hear "this drug makes people kill themselves." In reality, we're just seeing a phenomenon we've known about for a long time - that severely depressed people are most likely to commit suicide when they enter the upswing out of it - but because that upswing is pharmacologically-induced, now it's a side-effect. Dammit.