Do Anti-Depressants Cause Suicide?

Recently my wife sent me this link about anti-depressants being linked to suicide.  The article it brings up a lot of good points, but never really addresses the fundamental issue: is this a case of causation or merely one of correlation?  There has been a great deal written on the increase in suicide incidents following the introduction of anti-depressants but little written on what other factors may be playing a role.

First, how many people wait until their absolute darkest hour before finally admitting that they need help?  If someone is experiencing the absolute lowest point of their life, starts taking anti-depressants and then kills them self a few weeks later is their really any reason to say the drugs "caused" the death.  Probably not.

Secondly, as pointed out by my therapist, lots of times extremely depressed people don't pose that great a risk of suicide because, although they may want to kill themselves, they simply don't have the where with all to do anything about it.  Someone taking a new anti-depressant scrip will often experience a return of the energy level before they get the relief from the other symptoms of their depression.  Thus one is left with a depressed person who now has the energy to do something about it.  Did the anti-depressant cause suicidal thoughts?  No, but it will probably be blamed for them.

Next, consider the person who believes that anti-depressants are magic pills that will make everything ok.  They've been experiencing major depression and go to the doctor to receive a pill that they think will make them happy.  The don't supplement with therapy, they don't make any lifestyle changes, the just wait for their magic pill to make everything alright.  Well, it doesn't because there are no pills capable of doing that for longer than a few minutes (and the ones that can do the trick for a few minutes tend to be illegal and addictive).  Once they realize they aren't magically all better, their depression deepens, they begin to feel hopeless and finally, they take their own life.  Did the anti-depressant cause suicide?  No.

Why is this a big deal?  Because the moment a class of drugs gets tagged as dangerous the lawsuits begin.  Some lawsuits will be worthwhile, and some drugs need to be pulled off the market.  However, it never ends there, the other drugs in that category suffer from guilt by association.  Soon, the entire class of drugs becomes to expensive to make, and most everyone leaves the market segment.  Then people needing the drugs are left with no research being done and few products on the market.

It's scary because we know so little about brain chemistry.  Here's a dirty little secret: not even the pharmaceutical companies know how are drugs work.  It's all done by trial and error.  It is impossible to actually test an individual's brain chemistry because of a membrane surrounding the brain through which all blood passes on its way into and out of the brain.  you can't take a blood sample from inside this membrane (where the brain actually is).  This mean you can't ever accurately measure the brain chemistry of an individual.

So what's all this mean?  No one knows exactly how anti-depressants and mood stabilizers work.  People are now attempting to link them to suicide.  If anti-depressants are linked to suicide the liability associated with them will be too great for any company to risk making them.  If this chain of events continues, I don't have any anti-depressants to take and I kind of think they help me.

Comments

[Judy]

John,
You may remember that my son has taken his life.
It would be easy to believe that the anti-depressants were to blame.I do feel that they played a large part in his state of health at the time. However, my belief is that the management of his medication was more to 'blame', although I do not wish to lay blame at anyone's door.
I would love to write more and perhaps I will but am in a hurry tonight.
I really gain a lot from your blog, John and hope you do too.
You are doing a great job.
Judy

[Eric]

From my own experience of being bipolar II with a depressed baseline and frequent suicidal thoughts, antidepressants are not the cause for suicidal thoughts, they give the personal with suicidal thoughts enough energy to act on them. Suicide occurs more frequently not when a person is depressed but when they are having a mixed episode (features of mania and depression).

[Chris]

I got hospitalized for suicidal gestures and ideations after restarting Paxil.

[Heather]

Hi, I just wanted to say after reading your post John that I agree that you bring up some very valid points. However, I my self belive that it is a very real thing. I was never a "suicidal" person just a bit depressed. In my teen years I was put on antidepressants. I started to develope sucidal thoughts. That was followed by self mutalation and repeated attempts of sucide. This happened with every antidepressant that I was put on. I have taken Pamolar, Zoloft, Wellbutrin and one other that I cant remember. After a very scarry attempt at the age 15 that left me in cardiac intensive care for a week, I decided no more! I refused to take my meds and learned to cope on my own. I still wish that there was something I sould take to help as I still have bouts of depression. But I have not once ever, like before the drugs, thought of suicide. 12 years later I have 5 wonderful children one with bipolar, who takes meds no antidepressants. The fear of medication keeps me tring to deal on my own.

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