Adult patients taking the antidepressant drug paroxetine are at higherrisk of attempting to commit suicide than those not taking medication.A new analysis, published in BMC Medicine, of previous clinical data onparoxetine use adds the antidepressant to the list of SelectiveSerotonin Reuptake Inhibitors (SSRIs) that have been shown to increasesuicidal tendencies in adult patients with depression.
Ivar Aursnes and colleagues from the University of Oslo, Norway,reanalysed data from 16 selected paroxetine trials. In the trials,patients diagnosed with depression had been randomly given eitherparoxetine or a placebo drug. Neither the participants nor theresearchers conducting the initial studies knew what the participantshad been given. Aursnes et al. did a new statistical analysis of theresults of these studies, to evaluate the incidence of suicide attemptsin both groups. In their analysis, they took into account the amount oftime the participants had been exposed to paroxetine. Their resultsshow that there were seven suicide attempts in the group on paroxetine,and only one among the patients on placebo.
Paroxetine has been shown to increase suicidal attempt ratesin children and teenagers, but previous studies have failed to reach aconclusion as regards the effects of the drug on suicide attempt ratesin adult patients. Gunnell et al., in the February 19th 2005 issue ofthe BMJ, warned doctors about an increased risk of suicidal behaviourin patients treated with SSRIs. Their conclusion was based on analysesof clinical data submitted by the pharmaceutical companies that produceSSRIs to the Medicine and Healthcare products Regulatory Agency. ButGunnell et al.'s study had not properly included data on paroxetine.
Aursnes et al. conclude that "the recommendation ofrestrictions in the use of paroxetine in children and adolescentsconveyed by regulatory agencies latelyshould include usage in adults". They confirm that all SSRIs increasesuicidal tendencies in depressed adults, "the data strongly suggestthat the use of SSRIs are connected with increased intensity per yearof suicidal attempts".
Suicidal attempts in clinical trials with paroxetinerandomised against placebo
Ivar Aursnes, Ingunn Fride Tvete, Jorund Gaasemyr, Bent Natvig
BMC Medicine 2005, 3:14
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