A study at the University of Kuopio and Niuvanniemi Hospital in Finland found that suicidal patients taking antidepressants have an increased risk of additional suicide attempts but a decreased risk of dying from suicide.

The study analyzed 15,390 suicidal patients of all ages for an average of 3.4 years between 1997 and 2003. Among those studied, there were 602 suicides, 7,136 suicide attempts requiring hospitalization and 1,583 deaths recorded during follow-up. The risk of completed suicide was 9 percent lower among those taking any antidepressants than among those not taking them.

Much of the debate about whether antidepressants decrease suicide risk has focused on selective serotonin reuptake inhibitors (SSRIs), a category of relatively new but widely used antidepressants.

In 2005, the Food and Drug Administration (FDA) issued a "black-box warning," the most serious warning for prescription-drug labeling, on all SSRI boxes. The FDA said the drugs may promote suicidal thoughts in children, and may cause a possible increased risk for suicidal behavior in adults.

One type of SSRI, Prozac, had a 48 percent lower risk of suicide than those not taking medication. But for those taking Effexor XR, the study found that patients had a 61 percent increased risk. For youth in the study who took Paxil, there was an increased risk of death.

Dr. Jari Tiihonen and his colleagues, who authored the study, said that until now it has not been possible to demonstrate that the use of antidepressant medication decreases the risk of suicide.

Researchers said antidepressants seem to increase nonfatal suicide behavior may be explained by "a decrease in the incidence of violent and more fatal methods of suicide attempts, such as hanging and shooting."

The results of the study were published in the December 4, 2006 issue of Archives of General Psychiatry.

Source: Joyce Howard Price, "Suicide attempts rise with antidepressants," Washington Times, December 5, 2006.