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The Impact of Residual Symptoms in Major Depression
Pharmaceuticals 2010, 3(9), 2861-2883; doi:10.3390/ph3092861

Antidepressants and Suicide Risk: A Comprehensive Overview

1,2,* , 1
1 Department of Neurosciences, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Via Grottarossa 1037, 00189, Rome, Italy 2 McLean Hospital – Harvard Medical School, 115 Mill Street, Belmont, MA 02478, USA 3 The Richard Stockton College of New Jersey, P.O. Box 195 Pomona, NJ 08240, USA
* Author to whom correspondence should be addressed.
Received: 16 July 2010 / Revised: 20 August 2010 / Accepted: 26 August 2010 / Published: 30 August 2010
(This article belongs to the Special Issue Antidepressants)
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The annual worldwide suicide rate currently averages approximately 13 per 100,000 individuals per year (0.013% per year), with higher average rates for men than for women in all but a few countries, very low rates in children, and relatively high rates in elderly men. Suicide rates vary markedly between countries, reflecting in part differences in case-identification and reporting procedures. Rates of attempted suicide in the general population average 20–30 times higher than rates of completed suicide, but are probably under-reported. Research on the relationship between pharmacotherapy and suicidal behavior was rare until a decade ago. Most ecological studies and large clinical studies have found that a general reduction in suicide rates is significantly correlated with higher rates of prescribing modern antidepressants. However, ecological, cohort and case-control studies and data from brief, randomized, controlled trials in patients with acute affective disorders have found increases, particularly in young patients and particularly for the risk of suicide attempts, as well as increases in suicidal ideation in young patients. whether antidepressants are associated with specific aspects of suicidality (e.g., higher rates of completed suicide, attempted suicide and suicidal ideation) in younger patients with major affective disorders remains a highly controversial question. In light of this gap this paper analyzes research on the relationship between suicidality and antidepressant treatment.
Keywords: suicidal risk; antidepressants; pharmacotherapy; younger patients suicidal risk; antidepressants; pharmacotherapy; younger patients
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Pompili, M.; Serafini, G.; Innamorati, M.; Ambrosi, E.; Giordano, G.; Girardi, P.; Tatarelli, R.; Lester, D. Antidepressants and Suicide Risk: A Comprehensive Overview. Pharmaceuticals 2010, 3, 2861-2883.

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