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There is more damning evidence that a popular class of antidepressants that includes Prozac, Paxil and Zoloft may trigger intense suicidal thoughts in some patients.

New Canadian research shows that the suicide rate among seniors taking selective serotonin reuptake inhibitors was nearly five times higher than among those who were treated with other forms of antidepressants. That heightened risk lasts for about a month.

The study noted that suicides of a violent nature -- such as using a firearm or jumping from a building -- were especially common during the first month of treatment....

The original article can found in the Media Doctor archives.

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This is a valuable report of a study looking at the links between the use of SSRI antidepressants in seniors and suicide. While the story contains appropriate caveats which will lead readers not to jump to conclusions we think that a description of this kind of evidence needed further detail. The type of study the author describes is a retrospective cohort and not a randomized trial and there may be problems in interpreting such a study. For example it may be possible to conclude that the patients who took SSRIs and committed suicide were the most difficult to treat patients that is why they need " this kind of treatment" (or additional treatment), compared to those who were treated with other antidepressants. Unfortunately we don't know if this is true or not. In these kinds of studies there is the potential for a lot of confounders or pre-test risks. In other words, not everyone in the study may be at the same level of risk at entry as in a well conducted RCT. Fortunately there are alternatives to SSRI antidepressants and hearing about those alternatives may be useful for the reader yet we acknowledge that mentioning treatment options in this kind of story would not be expected as the study in question didn't look at alternative depression treatments only alternative antidepressant medication.

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