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Pharmacy Link

IS THERE ANY LINK AT ALL BETWEEN PROZAC AND SUICIDE?

Patients who take antidepressants are often suicidal to begin with, and they continue to be at risk as the antidepressant agent is escalated. Eighty-six published and unpublished reports claim that in a small minority of patients, Prozac, like other antidepressants, is associated with an increased propensity toward suicidal thoughts.

The reasons for this are unclear, but one commonly held hypothesis is that during the first few weeks of treatment, the antidepressant is thought to boost the patient’s energy before it alters his or her mood, who the result that a patient who may have previously been too slowed down by depression to do anything dangerous can now act on impulse rather than remain in a state of lethargy and immobilization.

A number of studies indicate that in the retarded depressed patient—that is, the patient whose thoughts and movements are slowed down or retarded by the depression—the potential for suicide may temporarily increase as the depression lifts. Reports of this phenomenon have circulated in the psychiatric literature for decades.

Another possible explanation is that in a small number of depressed suicidal patients, the administration of Prozac increases anxiety, which could conceivably push the patient over the edge. This increased anxiety and recklessness can be easily monitored by a trained psychopharmacologist, and if necessary, the patient can be hospitalized. Most depression experts agree that when a depressed patient complains of active suicidal thoughts, it is a psychiatric emergency and hospitalization is immediately needed. This is not something to fear.

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