No, I cannot have a normal peaceful morning, enjoying my breakfast, some light exercise, and looking at research. Today my peace was disturbed by reading that antidepressant drugs increase the risk for fatal suicides by 38x!!!
Let me tell you what a typical “odds ratio” (OR) or “risk ratio” (RR) is in the world of research.
When comparing two groups, such as one group that got nothing and another group that got some type of intervention like a drug, the ODDS RATIO is used to quantify how much more likely a noted effect is, whether good or bad. The number 1 (one) is defined as neutral.
If the OR is below ONE then the outcome is LESS LIKELY,
If the OR is above ONE then the association is MORE LIKELY.
Typically, we are looking at ORs in the range of 1.5 (which indicates 50% more likely) or 2 or 3, which would mean that the outcome is twice or 300% more likely. Those are already big numbers, because a 50% increase risk for an outcome like death means that the treatment is very dangerous, and this would be of massive importance if the treatment is given to several million people—this could result in hundreds of thousands of deaths.
Proof of what I am saying here comes from the example of the anti-inflammatory drug VIOXX which carried odds ratio (OR) or relative risk (RR) of 2-4 (ie, 2x-4x) for heart attack. That risk is so high when extrapolated to the general population that we are talking about hundreds of thousands of injuries and deaths from Vioxx, which is why it was removed from the US market in 2004.
In all my years of reading research, I don’t think I have ever seen any treatment provide any positive or negative outcome at the power of 38x—let alone when that outcome is 38x increased risk of fatal suicide!
Medscape1 2004: “In patients first prescribed an antidepressant within one to nine days before the date of suicidal behavior, the RR for suicidal behavior was 4.07 (95% CI, 2.89 - 5.74) compared with patients first prescribed an antidepressant 90 days or more before the date of suicidal behavior.
For fatal suicide, the RR was 38.0 (95% CI, 6.2 - 231.0) in patients first prescribed an antidepressant within one to nine days before the date of suicide compared with patients first prescribed an antidepressant 90 days or more before the date of suicide.
The authors conclude that the risk of suicidal behavior is increased in the first month after starting antidepressants, especially during the first one to nine days.
“We think the most likely explanation for this finding is that antidepressant treatment may not be immediately effective, so there is a higher risk of suicidal behavior in patients newly diagnosed and treated than in those who have been treated for a longer time,” the authors write.
“We cannot exclude what we think is a less likely possibility, namely that the drug itself ‘causes’ depression to worsen rapidly, thus leading to suicidal behavior.”
What do you think this data was titled in order to bring this medical emergency and public health catastrophe to the attention of all doctors and policy-makers?
The title should have been something clear and action-oriented because obviously a 38x increase in the risk of fatal suicide caused by a medical drug is a major public health emergency.
No—The title of this article was the nondescript and nonchalant “Risk of Suicidal Behavior Similar with Amitriptyline, Fluoxetine, and Paroxetine” that started with the first sentence, “The risk of suicidal behavior is similar for amitriptyline, fluoxetine, and paroxetine, according to the results of a matched case-control study published in the July 21 issue of JAMA.”
Nothing to see here. Just move along. How’s the weather? Did you get new socks? Did you see the game? JAMA reported a 4x increased risk for attempted suicide and a 38x increased risk for completed FATALITY…but hey, nothing too noteworthy because they buried the data inside the article under a boring title so that nobody would read it.
I found this data today because I'm writing my new book on migraine and obviously the American Academy of Neurology recently endorsed amitriptyline for the treatment of migraine, even though it's a pathetic and almost ineffective drug and certainly less effective than the much safer melatonin. I've already reported the fact that amitriptyline can cause massive weight gain of 20 to 30 pounds per year, which would be devastating for most young women who are the recipients of amitriptyline in the treatment of migraine. So beyond the devastating weight gain consequences, apparently it also increases the risk for suicide.
You have to understand that this should be considered malpractice and yet it's being endorsed at the highest levels of medicine by the American Academy of Neurology for the treatment of migraine headaches and here we are in the year 2026 and not only is this treatment medieval and superstitious and unscientific, but it should be considered malpractice.
No, this is not personalized medical advice for anyone. No, I will not manage anyone’s email accounts for them.
