Suicide Risk and the SSRIs
- Simon Wessely, MSc, MD, FRCP, FRCPsych, FMedSci;
- Robert Kerwin, MA, PhD, MBBCh, DSc, FRCPsych
- Author Affiliations: Department of Psychological Medicine, Institute of Psychiatry, London, England.
Since this article does not have an abstract, we have provided the first 150 words of the full text.
The selective serotonin reuptake inhibitors (SSRIs) were a welcome innovation in the treatment of depression. Although these drugs are no more efficacious than their predecessors, they are safer in overdose and more acceptable in terms of adverse effects.1 The popularity of the SSRIs in general, and of fluoxetine (Prozac) in particular, created its own problems. For instance, Prozac achieved a recognition normally given to household items in which the brand name has become identified with the generic product.
Selective serotonin reuptake inhibitors can cause agitation and activation, particularly at the start of treatment (eg, such sensations are not pleasant and resemble the akathisia associated with the neuroleptics2-3). In the setting of lowered mood, developing new aversive symptoms might further depress mood and increase the risk of suicide. Also, paradoxical reactions (ie, very occasionally causing agitation) are potential adverse effects of the benzodiazepines, and it is possible …
