Antidepressant suicide warnings 'may have backfired'
US warnings about the
risk of suicide in young people prescribed antidepressant medication may
have backfired, research suggests.
A study, in the British Medical Journal, showed a sudden fall
in antidepressant prescriptions and a rise in suicide attempts after
media reports of the connection.
The team at Harvard Medical School said the unintended effect was "disturbing".
Experts said similar changes had been seen in other countries.
In 2003, there were concerns about an increased suicide risk from some antidepressants. It led to the US Food and Drug Administration changing the medicine warnings and widespread media reports.
However, there was concern that the reports were exaggerated and missed out the benefits of antidepressants.
Big fall
The study, which followed 2.5 million teenagers and young
adults between 2000 and 2010, showed an immediate impact of the
warnings.
Prescriptions fell by a third in teenagers and by a quarter in young adults.
The number of suicide attempts increased by 22% in teenagers and 34% in
young adults. Overall it led to an additional 77 attempts, the
researchers estimated.
The report concluded: "It is disturbing that after the health
advisories, warnings and media reports about the relation between
antidepressant use and suicidality in young people, we found substantial
reductions in antidepressant treatment and simultaneous, small but
meaningful increases in suicide attempts."
One of the researchers, Prof Stephen Soumerai, said: "This is
an extraordinarily difficult public health problem, and if we don't get
it right, it can backfire in serious ways.
"These drugs can save lives. The media concentrated more on the relatively small risk than on the significant upside."
'Powerful impact'
Prof Keith Hawton, the director of the centre for suicide
research at the University of Oxford in the UK, said: "The results of
this study are important.
"Such findings illustrate the powerful impact that such announcements can have on clinician behaviour.
"Until now there has not been convincing evidence that such changes in practice have affected suicidal behaviour.
"The US study suggests that this may have happened, although fortunately without evidence of an increase in actual suicides."
Dr Christine Lu, of Harvard, told the BBC: "There are several
lessons for us to consider. Drug risk communication is a big field and
we need to be better next time. Any communication can have intended and
unintended consequences.
"And I think a key message is to remind
ourselves not to consider only the new evidence on any drugs, but also
consider its risk and the benefits, and undertreating the original
condition itself."
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