Antidepressants can raise the risk of suicide, biggest ever review finds
Antidepressant use doubles the risk of suicide in under 18s and the risks to adults may have been seriously underestimated, researchers found
(Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports
http://www.bmj.com/content/352/bmj.i65 )Antidepressants can raise the risk of suicide, the biggest ever review has found, as pharmaceutical companies were accused of failing to report side-effects and even deaths linked to the drugs.
An analysis of 70 trials of the most common antidepressants - involving more than 18,000 people - found they doubled the risk of suicide and aggressive behaviour in under 18s.
Although a similarly stark link was not seen in adults, the authors said misreporting of trial data could have led to a ‘serious under-estimation of the harms.’
Professor Peter Gotzsche, Nordic Cochrane Centre
For years families have claimed that antidepressant medication drove their loved ones to commit suicide, but have been continually dismissed by medical companies and doctors who claimed a link was unproven.
The review - the biggest oif its kind into the effects of the drugs - was carried out by the Nordic Cochrane Centre and analysed by University College London (UCL) who today endorse the findings in an editorial in the British Medical Journal (BMJ).
After comparing clinical trial information to actual patient reports the scientists found pharmaceutical companies had regularly misclassified deaths and suicidal events in people taking anti-depressants to "favour their products".
Experts said the review's findings were "startling" and said it was "deeply worrying" that clinical trials appear to have been misreported.
Dr Joanna Moncrieff from University College London said: "People in the United Kingdom are consuming more than four times as many antidepressants as they did two decades ago. Despite this, we still do not fully understand the effects of these drugs.”
The UK now has the seventh highest prescribing rate for antidepressants in the Western world, with around four million Britons taking them each year - twice as many as a decade ago at a cost of more than £200 million a year for the 53 million prescriptions now written.
Dr Joanna Moncrieff, University College London
Although NHS guidelines state that under 18s should not be given antidepressants there are more than 100,000 prescriptions for Prozac each year for teenagers, despite reviews showing that the drugs are no more effective than counselling.
The review looked at the five most common drugs prescribed for depression in Britain - including Prozac.
It analysed the published summary reports provided by pharmaceutical companies to drugs regulators and compared it with the raw data from clinical trials.
Tarang Sharma of the Nordic Cochrane Centre, Copenhagen, Denmark admitted: “The analysis suggests that clinical study reports, on which decisions about market authorisation are based, are likely to underestimate the extent of drug related harms.”
Four deaths were misreported by one unnamed pharmaceutical company, who claimed they had occurred after the trials had stopped.
One patient strangled himself unexpectedly after taking venlafaxine but because he survived for five days, he was excluded from the results because it was claimed he was no longer on the trial while he was dying in hospital.
More than half of the suicide attempts and suicidal thoughts had been misrecorded as emotional instability or worsening of depression. In summary trial reports from the drugs giant Eli Lilly, suicidal attempts were missing in 90 per cent of cases.
One father whose son committed suicide after taking Citalopram has been monitoring suicides related to antidepressant medication for the last three years and has set up the anonymous campaigning website AntiDepAware.
So far this month there have been at least 35 inquests with deaths linked to antidepressants. Last year there were more than 450.
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