Suicide risk in patients with anxiety disorders: a meta-analysis of the FDA database.
BACKGROUND
Previous reports of suicide risk in patients with anxiety disorders have been inconsistent.


METHODS
Using the FDA database, we assessed suicide and suicide attempt risk among patients, participating in recent clinical trials evaluating new anti-anxiety medications, with diagnosis of panic disorder (PD), social anxiety disorder or social phobia (SP), generalized anxiety disorder (GAD), post traumatic stress disorder (PTSD), and obsessive compulsive disorder (OCD).


RESULTS
Overall, among 20076 participating anxious patients, 12 committed suicide and 28 attempted suicide. The annual suicide risk rate was 193/100000 patients and annual suicide attempt risk was 1350/100000 patients.


CONCLUSIONS
Clinical trial data have limited applicability to clinical practice. Participants in clinical trials are a highly selected, nonrepresentative sample of the clinical population. A number of patients never complete clinical trials and thus data are based on a limited sub-sample. These trials were not primarily designed to assess suicide risk.


CONCLUSIONS
Suicide risk in patients with anxiety disorders is higher than previously thought. Patients with anxiety disorders warrant explicit evaluation for suicide risk.
Khan
Arif
A
Northwest Clinical Research Center, 1900-116th Avenue NE 112, Bellevue, WA 98004, USA. arif@accessone.com
Leventhal
Robyn M
RM
Khan
Shirin
S
Brown
Walter A
WA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000188:drug therapy / Q000401:mortality* / Q000523:psychology; D002423:Cause of Death; D002986:Clinical Trials as Topic; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy / Q000401:mortality / Q000523:psychology; D012306:Risk; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000401:mortality / Q000523:psychology; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014486:United States Food and Drug Administration; D000092864:Suicide Prevention