New health alert over antidepressants as study finds a 'rare but serious' risk of suicide for patients on pills
By BEN SPENCER MEDICAL CORRESPONDENT FOR THE DAILY MAIL
PUBLISHED: 17:00 EDT, 24 June 2019 |
Taking antidepressants raises the risk of suicide, a study suggests.
Experts last night warned that patients should be told of the dangers before they start taking the pills.
The research found depressed people on the drugs were more than twice as likely to attempt suicide as similar patients who were not taking them.
Study leader Dr Michael Hengartner, of Zurich University in Switzerland, said: ‘We can be confident that these drugs are producing an excess rate of suicides, beyond the depression itself.
‘There is no doubt that this must be a response to the pharmacological effect of the drugs themselves.’
Although the increased risk appears stark, in real terms the researchers calculated only 77 extra suicides per 100,000 patients taking the pills.
Scientists acknowledge that for many people, antidepressants are a lifeline.
But with more patients in Britain taking them than those in almost every other Western country, many doctors believe millions are being put at risk.
Some seven million adults in England took the drugs in 2016/17. The researchers believe that for some, the chemicals in the pills can trigger severe agitation, restlessness and even psychotic episodes.
Dr Hengartner added: ‘I’m not saying no one should be given antidepressants, but doctors should be much more conservative about how they use them. One in six adults being given antidepressants like in the UK – that is alarming.
‘Patients should be informed of the risks and they should be monitored.’
The study found that people prescribed antidepressants were 2.5 times more likely to attempt suicide than depressed people taking placebo pills.
The research, published in the journal Psychotherapy and Psychosomatics, combined the results of 14 studies involving nearly 32,000 people taking a variety of antidepressants.
The authors stressed that the real-terms rise in risk was small, calculating that for every 100,000 taking the pills, there would be an extra 413 suicide attempts and an extra 77 suicides. But in England, this could add up to thousands of extra suicides.
The highest risk was found to occur in the first four weeks after the treatment begins.
Dr Hengartner said: ‘Our study signals a rare but serious risk that needs to be brought to the attention of practitioners, particularly when starting or stopping antidepressants.’
Psychotherapist Dr James Davies, of the University of Roehampton, said: ‘It is known that antidepressants increase the risk of suicide among young people and adolescents, and for this reason their use is restricted among these patient groups.
‘However, this research indicates that similar risks also occur for some adults.
‘This new evidence should be reviewed by regulators, reflected in clinical guidelines and brought up in conversations between doctors and their patients.’
Professor Wendy Burn, president of the Royal College of Psychiatrists, pointed out that the study was based on US data, and four of the 14 drugs assessed are not available in the UK.
But she added: ‘This is an important issue, which we need to understand better. As with all medications, we need to balance the potential benefits and risks of harm from starting, continuing and stopping their use.
‘It is vital that people prescribed antidepressants are monitored closely, made aware of possible side effects and know how to seek help if they experience them.’
Last month, the Royal College of Psychiatrists acknowledged for the first time that coming off the pills can cause severe side effects lasting months – with the worst-hit suffering nausea, anxiety and insomnia.
And two weeks ago, the European Medicines Agency issued guidance suggesting the most common pills – selective serotonin reuptake inhibitors or SSRIs – can cause long-term loss of sexual function.
I wish someone had warned me of side effects
Steph Williams started hearing the voice in her head barely a day after her GP increased the dose of her antidepressant.
‘It said: “That’s it, we’ve had enough”,’ recalls Steph, 27, of Featherstone, near Wakefield in West Yorkshire.
‘I picked up my phone and started researching how to commit suicide.’
That was in 2016. Steph had been on antidepressants since 2007 when, at the age of 16 and shortly after starting college, she began to suffer panic attacks which developed into agoraphobia. Leaving the house had become a daunting prospect.
Later, she would be diagnosed with borderline personality disorder, a condition in which patients suffer from extreme emotional instability and can literally feel uncomfortable in their own skin. The condition had been triggered by years of bullying and abuse.
In 2007, her family doctor had prescribed citalopram, a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI), used to treat depression and panic attacks. He started her on 10mg a day, increasing the dose to 20mg within two months.
She still doesn’t know if the citalopram helped because at about the same time that she started taking the drug she began having regular sessions with a counsellor, a woman she describes as ‘amazing’.
‘She was the first person I had spoken to about the abuse and the bullying,’ Steph recalls. ‘It took two years but she helped me to stand on my own two feet again.’
In 2012, aged 20, Steph had recovered sufficiently to get married and move out of her parents’ home. Her husband, whom she later divorced, was in the military. They moved to a number of different places with his job and in 2016 Steph found herself in Newquay, Cornwall.
Still taking antidepressants – at 18 she had been switched to Cipralex, another type of SSRI – her anxieties came and went. But in August 2016 her remote location and a series of family problems conspired to send her into a spiral of anxiety.
‘Members of my family had serious health issues and I wanted to be there for them, but I was at the other end of the country,’ she says. ‘The stress just built up and I ended up having a nervous breakdown.’
Her GP’s solution was to increase the dose of her drug from 15mg to 20mg – and that was when the nightmare really began.
Suddenly ‘it was like my body was just trying to take off,’ Steph says. ‘My nerves were reacting so badly, it was as if they were vibrating. I couldn’t sit down, I felt a constant need to move, I was sweating and pacing the floor from morning to night. I couldn’t eat or even brush my teeth because I would gag. I couldn’t even talk or hold a pen.’
But what she could do was hear the voice, which was very clearly telling her to kill herself. If she had been left alone for long enough, she believes, she would have done.
‘I managed to text my mum and dad to say “Please help me, please come and get me”,’ and her parents drove down from Yorkshire to take her back home.
But ‘I just put two pairs of trousers in the suitcase’, Steph recalls. ‘I had no intention of living much longer than one week. My parents lived near a bridge over a railway line and I just knew I was going to jump from it.’
Her life was saved, she says, partly because of her fear of leaving the house but mainly because either her mother or father stayed with her constantly.
Back home, she registered with a new surgery and on her first visit, accompanied by her father, she told the GP about her suicidal thoughts. His solution was to switch her from Cipralex to sertraline, another SSRI antidepressant.
The rapid weaning-off from Cipralex – her dose was lowered in 5mg stages from 20g to nothing in just 12 days – ‘felt like hell’. All the symptoms of restlessness and anxiety multiplied and, if anything, she felt even more suicidal.
‘For a while all I could think was that I had to get sufficiently better so I could face leaving the house for long enough to get to the bridge.’
She felt no improvement on the new drug, sertraline, so within a month the GP increased the dose from 50mg a day to 100mg – and added 2mg of diazepam, to be taken for anxiety as needed.
Over the past two years Steph has gradually come to grips with her condition, thanks mainly to compassionate care and counselling as opposed to the drugs, she believes. From time to time, the suicidal thoughts still return and she still suffers significantly from anxiety.
She has nothing but praise for her local mental health team, her local A&E where from time to time she goes ‘to keep myself safe when I start to feel that I might harm myself’ and for her parents, who have provided constant support.
In 2017, Steph felt strong enough to move out of her parents’ small bungalow into a rented home of her own nearby. That same year she and her husband divorced.
Thanks to the support of a government-sponsored training programme, has been able to set up as a nail technician, working at home for a few hours a week. That, she says, ‘has given me a sense of purpose and confidence after such a long time of feeling like I couldn’t do anything’.
She’s still on her daily dose of 100mg of sertraline, but intends to try coming off the drug just as soon as she has managed to wean herself off the diazepam, which has caused physical dependency issues – she’s an administrator for an online benzodiazepine recovery group.
With everything she knows now, Steph wishes she had never been put on antidepressants in the first place.
‘I was 16, I didn’t know anything about the drugs, and nor did my parents – they were just desperate for anything that would help me,’ she says.
‘I obviously needed help but I honestly believe that good counselling, and having someone equip me with the skills necessary for coping for life, would have been a far better solution.’
Now, she says, she hopes others will learn from her story.
New health alert over antidepressants as study finds a 'rare but serious' risk of suicide for
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