Antidepressant therapy and the risk of suicide among patients with major depressive disorders

The world-wide annual suicide rate currently averages approximately 13/100,000 (0.013%/year), with higher average rates for men than women in all but a few countries, very low rates in children, and relatively high rates in elderly men. Suicide rates vary markedly among regions of the world, countries, and locales, in part reflecting differences in case-identification and reporting procedures. Rates of attempted suicide average 20-30 times higher than rates of completed suicide in the general population, but are probably under-reported. A highly controversial question is whether antidepressant treatment modifies the risks of various aspects of "suicidality" among patients with major depressive disorders. Research on the relationship between pharmacotherapy and suicidal behavior was virtually unknown until a decade ago. A minority of ecological studies and most large clinical studies have found that decreases of suicide rates by region or time are correlated with higher rates of prescribing modern antidepressants. However, other studies and data from brief, randomized, controlled trials in patients with acute major depression have found increases for patients of some ages, particularly for the risk of suicide attempts, as well as increases in suicidal ideation in the young. Although other pharmacological treatments, such as clozapine and lithium, appear to have sound evidence for reducing the risk of attempted and completed suicide, in this paper we proposed to analyze the relationship between suicidality in depressed adults and only antidepressants. © 2011 by Nova Science Publishers, Inc.