Klinische Depression

What is the Risk of Suicidality in Depressive Adult Patients Using SSRIs? A Meta-Analysis of RCTs

Abstract

Al-Mutawa N, Andriotti T and Elmahdi H

Introduction: Selective Serotonin Reuptake Inhibitors (SSRIs) are among the most commonly prescribed medications particularly for patients with depressive disorders. Concerns related to increase risk of suicidality associated with the use of SSRIs were raised since early 1990s. Recent studies show inconclusive and conflicting results about this association. Meta-analysis based on Randomized Controlled Trials (RCTs) in depressive disorders has not been done recently.
Objective: To establish whether there is increased risk of suicidality with the use of SSRIs compared to placebo in the treatment of depressive disorders in adults.
Method and design: Meta-analysis of Randomized Controlled Trials (RCTs).
Data sources: I searched for relevant systematic reviews and RCTs in Medline and Cochrane library database. I checked reference lists of included trials. I included trials from Jan 2000 to September 2016.
Selection criteria: Published systematic reviews of randomised controlled trials comparing SSRIs with placebo in adults diagnosed with a depressive disorder were eligible for inclusion.
Data collection and analysis: One review author selected the trials, assessed their quality. I use random effect meta-analysis. I used Odds Ratio (OR) to summarize dichotomous outcomes.
Results: In the 5 studies identified, 556 suicidal events were detected in 71628 patients treated with SSRI for depressive or other disorders. Pooled OR=0.97(95%CI 0.85-1.1).
Conclusion: These findings support that there is no increased risk of suicidality in adult patients treated with SSRI for depression.