Elderly at risk using mood drugs: Study
Danger in first month of antidepressant use
Suicide rate much higher in early therapy
May 1, 2006. 06:35 AM
Elderly patients who are prescribed a popular brand of antidepressants are five times more likely to commit suicide during the first month of therapy than those taking other drugs, a new study shows.
The study by the Institute for Clinical Evaluative Sciences, an independent research group, released today in the American Journal of Psychiatry, looked at 1,142 suicides among Ontario residents older than 65 over nine years.
While the majority weren't taking antidepressants, those who did were at far higher risk of committing suicide in the first month of treatment.
The antidepressants, called selective serotonin reuptake inhibitors, or SSRIs — which include Prozac, Paxil and Zoloft — have already been the subject of strong warnings from drug companies and class-action lawsuits over their increased risk of suicide among children, adolescents and adults.
In Canada, where an estimated 1 million suffer from depression, the number of prescriptions for SSRIs has doubled in the past five years, with 17.5 million filled last year alone.
No one has studied such a large population or looked specifically at seniors, despite the large numbers of them who are prescribed these drugs, said Dr. David Juurlink, the study's lead author.
The ICES researchers linked coroners' records with patient prescription data between 1992 and 2000 and found that one in every 3,300 seniors who started taking the drugs in the past month committed suicide.
Although the risk is small, "when you multiply it by the millions of Canadians taking these drugs, then you're talking about big numbers of people," Juurlink said.
Doctors not only should closely monitor patients taking the drugs in the first month of therapy, he said, "but we need to be more judicious in how we use these drugs. We prescribe them very liberally.
"The drugs are meant to treat depression, they're not a treatment for financial problems or job dissatisfaction or any of the other sort of unhappiness people might experience in life," he said.
"Because they are perceived as very safe, we are too free with them."
Suicide is the 11th leading cause of death in the elderly, he said.
A second Canadian study in the journal found bright, artificial light therapy is as effective as antidepressants in the treatment of winter depression.
The study, co-authored by Dr. Anthony Levitt, chief of psychiatry at Sunnybrook Health Sciences Centre, found both treatments produced an improvement in 67 per cent of cases treated.
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