The use of anti-depressants, or SSRIs as they are known in the trade, has long been associated with some controversy among mental health professionals and the broader community. Mental illness advocacy groups such as Beyond Blue wisely steer a middle course on the question, noting that each case of mental illness is different and the treatment will vary accordingly.
The debate over the efficacy of anti-depressants has not been helped by the media over recent years. There is a tendency to highlight the most negative findings to create a good news story. When the ABC’s Four Corners ran a program in 2003 on a supposed link between suicide and anti-depressants, phones rang off the hook at surgeries the next morning as panicked patients called to speak with their doctor.
A new study, published in the current edition in the Canadian Medical Association Journal provides support for the use of anti-depressants to substantially reduce the incidence of suicide among adults and the elderly. The study also confirms that care needs to be taken in monitoring young people who are on anti-depressants.
What is so useful about this study, conducted by three Italian researchers from the World Health Organization Collaborative Centre and the Department of Psychiatry at the University of Verona, is that it tests the veracity and robustness of eight previous studies and samples.
This research finds that SSRI’s can decrease the risk of suicide by over 40 percent among adults and by over 50 percent among elderly people. These are significant numbers and as Carrado Barbui, Eleonora Esposito and Andrea Cipriani the study’s authors note, they provide reassurance for doctors “that prescribing SSRIs to patients with major depression is safe.”
But when it comes to adolescents and children the use of SSRI and an increased risk of suicide can be linked, the study found, although this finding is couched cautiously because the study says that while adults can be prescribed SSRIs where depression is mild and severe, when it comes to adolescents and children they are generally only used in cases where the patient has more severe depression and is therefore potentially more suicidal.
Alarmingly, because of reports about the possible increased risk of suicide among young people who are prescribed SSRI’s, some doctors may be avoiding diagnosing depressive illness and therefore avoiding the dilemma of having to decided whether or not to prescribe anti-depressants. Writing in the same edition of the CMA Journal, two American researchers, Robert Gibbons and John Mann say that “concerns about the risk of suicide in youth have led not only to fewer SSRI prescriptions without substitution of alternative medications or psychotherapies, but also to a decrease in predicted rates of diagnosis of mood disorders,” by doctors.
Anti-depressants have saved many lives and helped millions of people around the world over the past couple of decades, as this study confirms, but we do need to ensure that young people and children can access these medications safely or that alternative effective treatments for depression are available to them and their doctors.
Disclaimer; I have been taking SSRI drugs on a daily basis since 1997.