Fluoxetine suicide rates

S X d X o Half-life is 48-72 hrs, thus onedose/day. Takes weeks to achieve equilibrium blood levels. Life-threatening reaction possible with monoamine oxidase inhibitors. Do not use within 2 weeks. Increased suicide rate reported in patients taking fluoxetine. 

The side effects of antidepressants, sometimes very unpleasant, olten lead patients to interrupt their treatment or to reduce the drug dose, which involves a great risk in view of the high relapse rate and danger of suicide in depression. The newer antidepressants, such as trazodone, fluoxetine and other SSRIs and moclobemide, are characterized by better tolerability and lower toxicity and are therefore preferred in the treatment of outpatients and elderly patients (Rudorfer and Potter, 1989). A detailed list of general and specific common side effects associated with the newer generation of antidepressants is seen in Table 1.7. 

An unpublished document obtained during discovery in product liability suits against the drug company disclosed that Eli Lilly, the manufacturer of fluoxetine (Prozac), had evaluated the comparative rates of suicide attempts on fluoxetine, amitriptyline, and placebo (the documents are available from http //www.breggin.com). The data were generated during controlled clinical trials conducted for the FDA approval process for Prozac for depression. On the basis of the company s data for controlled clinical trials, patients taking fluoxetine were 12 times more... 

In an analysis of data from the National Institute of Mental Health Collaborative Depression Study in 643 patients with affective disorders who were followed up after fluoxetine was approved by the FDA in December 1987 for the treatment of depression, nearly 30% (n = 185) took fluoxetine at some point (18). There was an increased rate of suicide attempts before fluoxetine treatment in those who subsequently took fluoxetine. Relative to no treatment, fluoxetine and other antidepressants were associated with non-significant reductions in the likelihood of suicide attempts or completions. Severity of psychopathology was strongly associated with increased risk, and each suicide attempt after admission to the study was associated with a marginally significant increase in the risk of suicidal behavior. The authors concluded that the results did not support the speculation that fluoxetine increases the risk of suicide. 

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