Suicidality and fluoxetine: is there a relationship?
A recent report of six depressed patients who developed intense, violent suicidal preoccupation after 2 to 7 weeks of fluoxetine treatment prompted the authors to survey 27 psychiatrists who treated 1017 depressed outpatient with antidepressants during 1989: 3.5% (8/231) of those treated with fluoxetine alone, 6.5% (4/62) of those treated with fluoxetine and tricyclics, 1.3% (5/385) of those treated with tricyclics alone or with lithium, and 3.0% (3/101) of those treated with other antidepressants became suicidal only after treatment with these antidepressants was initiated. None of these patients, however, reported intense suicidal thoughts of the degree described in the previously reported six cases. The difference in incidence of suicidal ideation occurring only after initiation of treatment was not significant between patients treated with fluoxetine alone and those receiving the other antidepressant treatments.
Fava
M
M
Clinical Psychopharmacology Unit, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
Rosenbaum
J F
JF
D000553:Ambulatory Care; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects / Q000627:therapeutic use; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004359:Drug Therapy, Combination; D005473:Fluoxetine / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008094:Lithium / Q000009:adverse effects / Q000627:therapeutic use; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D000929:Antidepressive Agents, Tricyclic; D008996:Monoamine Oxidase Inhibitors; D005473:Fluoxetine; D008094:Lithium