The National Institute of Mental Health (NIMH), part of the National Institutes of Health, has announced that it is funding five new research projects that will explore the connection between antidepressant drugs, especially serotonin reuptake inhibitors (SSRIs), and suicidal thoughts and actions. According to the NIMH, “the use of SSRIs in children and adolescents has become controversial†because of the “potential for SSRIs to prompt suicidal thinking†in those cohorts.
“These new, multi-year projects will clarify the connection between SSRI use and suicidality,†said NIMH Director Dr. Thomas Insel. “They will help determine why and how SSRIs may trigger suicidal thinking and behavior in some people but not others, and may lead to new tools that will help us screen for those who are most vulnerable.â€
One study, conducted by Dr. Kelly Kelleher of Columbus Children’s Hospital and of the Ohio State University and Dr. Joel Greenhouse of Carnegie Mellon University, will analyze existing FDA data regarding antidepressant medication use and suicidal behavior among youth, adults and older adults. A second, led by Dr. Marcia Valenstein of the University of Michigan, will examine the records of nearly 1 million individuals from the U.S. Department of Veterans Affairs National Registry for Depression, Medicare records, and the National Death Index to assess the relationship between antidepressants and suicide attempts and/or deaths.
The third project involves the notion of an “activation syndrome†in which SSRIs may trigger agitation, irritability, and distinct changes in mood in pediatric patients. Here, the University of Florida’s Dr. Wayne Goodman will study patients with obsessive compulsive disorder, a condition not normally associated with suicidal thoughts or actions. A fourth, conducted by Dr. Sebastian Schneeweiss of Brigham and Women’s Hospital, will compare several large datasets of SSRI users to measure rates of suicidality, identify any social and demographic factors that may affect behavior, and also gauge the effectiveness of the FDA’s preventive actions. The final study, led by Dr. Prudence Winslow Fisher of the New York State Psychiatric Institute, will attempt to improve screening and monitoring methods used by healthcare professionals to determine the risk of suicidality in antidepressant patients.
Earlier this month, the U.S. Food and Drug Administration (FDA) warned that the use of antidepressants may increase suicidal thoughts and behavior in young adults between the ages of 18 and 24. The agency based that finding on data from 372 studies, which together included roughly 100,000 patients and 11 different modern drugs. A week later, the FDA’s Psychopharmacologic Drugs Advisory Committee recommended changes to the “black box†label warnings that were added to SSRIs last year. Current warnings highlight the risk of suicidal behavior in children and adolescents, but the committee urged that the warning be expanded to include young adults.
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