Fluoxetine, Venlafaxine Tied to Drop in Adult Suicide Behaviors

For youth, no difference in suicide thoughts or behavior with antidepressant treatment

MONDAY, Feb. 6 (HealthDay News) -- Treatment with the antidepressants fluoxetine hydrochloride and venlafaxine hydrochloride is associated with a reduction in suicidal thoughts and behavior in adult and geriatric patients and has no impact on such thoughts or behavior in youths, according to a study published online Feb. 6 in the Archives of General Psychiatry.

To investigate the short-term safety of antidepressants, Robert D. Gibbons, Ph.D., from the University of Chicago, and colleagues reviewed data from 12 adult, four geriatric, and four youth randomized controlled trials of fluoxetine, and 21 adult trials of venlafaxine. Data on suicide items, reports of suicide attempts, and suicide during active treatment were collected for 9,185 patients: 2,635 adults, 960 geriatric patients, and 708 youths who took fluoxetine; and 2,421 adults who took immediate-release and 2,461 who took extended-release venlafaxine.

The investigators found that, for adults and geriatric patients randomized to fluoxetine or venlafaxine, there was a decrease in suicidal thoughts and behaviors over time, compared with placebo. No differences were seen for youths. In adults, a reduction in depressive symptoms led to the decrease in suicide ideation and attempts. Depression severity improved with medication and was significantly correlated with suicide ideation or behavior in all age groups.

"Fluoxetine and venlafaxine decreased suicidal thoughts and behavior for adult and geriatric patients. This protective effect is mediated by decreases in depressive symptoms with treatment," the authors write. "For youths, no significant effects of treatment on suicidal thoughts and behavior were found, although depression responded to treatment."

Two authors disclosed financial ties to the pharmaceutical industry. One author served as an expert witness for the pharmaceutical industry in cases related to antidepressants and suicides.

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