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Anti-depressants may lead to suicide

Isabel M. Estrada Portales /AFP
07/08/2005

The US Food and Drug Administration has issued new guidelines saying that adults who take anti-depressants must be closely watched for potential suicidal tendencies.
The warning, placed on the FDA's Internet site Friday, is stronger than an earlier one issued on March 2004.

The regulatory agency cites new publications in saying that people who are taking anti-depressants have a higher risk for suicidal thoughts than the general population.

It proposes labeling anti-depressant drugs with specific warnings to say adults using them require closer attention for signs their depression may be worsening, and for increased suicidal thinking or behavior.

In 2004, the FDA called on pharmaceutical laboratories to place the strongest warnings on its packaging, with a black box on labels of anti-depressants that have shown possible links to suicidal tendencies in children.

Among pharmaceutical companies manufacturing anti-depressants, Zoloft maker Pfizer said that it already issued warnings for adults taking the drug for depression to be monitored closely.

The FDA said on its website that Eli Lilly's drug Cymbalta, authorized for use as an anti-depressant, had produced higher than normal levels of suicidal tendencies during clinical trials.

However, Eli Lilly defended its product, saying that the 14 suicide attempts out of 12,000 people who took part in the trials was similar to the national average.

Statistics from the US Agency for Healthcare Research and Quality show that white non-Hispanics used antidepressants more than twice (10.6%) as much as black non-Hispanics ( 4.0%) and Hispanics (3.6%) in 2002.

Moreover, the percentage of other non-Hispanic races using an antidepressant was higher than the percentage of Hispanics using an antidepressant in 2002 (5.4 percent versus 3.6 percent).

A study by doctor Humberto Marin, published in the Psychiatric Times in October 2003, shows that regarding mental health, Hispanics have both fewer visits and less chance of their mental problems being detected.

“Latinos with fair and poor English proficiency reported approximately 22% fewer physician visits than non-Latinos,” the study says. “In a review of 19,309 patients and 349 internists and family physicians, Hispanics and African-Americans were found to be at higher risk for non-detection of their mental health problems.”

The expression and reporting of psychiatric symptoms is partially determined by culture. “I will not debate here the controversial issue of misdiagnosis in Hispanics,” Dr. Marin says. “However, Hispanics with bipolar disorder are more likely to be labeled with schizophrenia, and Hispanics with depression (and probably anxiety) tend to somatize distress, reporting an excess of somatic and hypochondriacal features.”