01 September, 2008

Suicide Risk Increases With Medication

Increased rates suicide and violent behavior have been linked to anti depressant medication. Federal drug regulators are now investigating links with other medications to suicide. Among the drugs being investigated are an asthma medication, drugs for controlling seizures, and even a substance used to assist those who want to quit smoking.

Drug companies insist that a cause and effect relationship has not been proven. During clinical trials, no suicides were reported. Doctors hold a concern that worries over suicide risk may cause their patients to think twice about taking these medications. However, families who have experienced the sudden, unexpected loss of a family member feel that they should have been given the information to make an informed choice.

Recently, the FDA pulled together a panel of scientific advisors to study 210 clinical trials of eleven anti seizure drugs. The panel found a ‘slight’ increase in incidents of suicidal thoughts or behavior. The survey did not indicate which drugs were more or less likely to foster risk. Even a two out of a thousand increase can result in large numbers of people at risk when the drugs are prescribed to millions of people. Certainly, the families directly effective find no solace in how ‘small’ those numbers seem.

The FDA is considering how to communicate the risk to patients without causing alarm. The panel did not advise putting a strong warning on the drugs’ labels.

Compare these numbers to the two out of a thousand whose lives are improved by certain blood pressure medications which are avidly prescribed throughout the world. It would seem the medical companies find those numbers significant on other fronts.

A group at Columbia University developed a method to assess the suicide risks of drugs. They collect and analyze suicidal thoughts and actions of people enrolled in clinical trials. The FDA funded the research, but only requires use of assessments on a case-by-case basis. The oversight is curious to many since its use could possibly help identify risks before a medication goes on the market.

"Whether or not any of these drugs cause suicidal thoughts and behavior is the critical question we need to answer; up to now, we have not answered that," said Kelly Posner, a Columbia researcher who led the effort to develop the screening system. "Debunking false notions of risk is just as important to the public health as knowing about risks that exist."

Behavior can be affected by chemical changes in the brain. This is the basis for prescription of drugs for depression, anxiety, or other psychiatric illnesses. Other drugs can also affect the brain. Little is known about these effects.

The brain is protected by a semi permeable membrane. Most chemicals are prevented from entering the brain in this way. Yet, others are allowed in differing amounts.

Psychiatric drugs, of course, cross the blood-brain barrier. Presumably, the same is true of anti-seizure medication. Other drugs may pass the barrier in limited amounts. However, few studies are done on the interaction of drugs with the blood-brain barrier. Many of those which have been done are limited to animal studies. Such information can be useful, but is limited in its relevance to human brains. Fewer studies, still, have been done on what affects those chemicals have once they come in direct contact with the master control center of the human body.

Regardless of the purpose for which a drug is prescribed, there is potential for psychiatric side effects if it passes the blood-brain barrier. Drugs for asthma, weight control, quitting smoking, and even certain heart medications may have potential for changing a person’s behavior and mood.

A list of some prescription medications for which concerns have been raised involving suicidal thoughts and actions:

• All antidepressants: Drugs such as Prozac, Paxil, Wellbutrin and Zoloft carry required warnings that the medications can increase suicidal thinking and behavior in some children, adolescents and young adults.

• Anticonvulsives: Drugs such as Depakote, Lyrica and Neurontin are used to treat seizures and other conditions. A recent FDA analysis found a small increased risk of suicidal thinking and behavior. An advisory panel recommended against applying the agency's strongest warning to the drugs.

• Chantix: The FDA is investigating whether the smoking cessation drug triggers psychiatric symptoms.

• Singulair: The FDA is investigating whether the drug for asthma and allergies can prompt suicidal thoughts.

• Accutane: The acne drug carries a warning that it may cause suicidal thoughts and behavior in rare cases.

Increasing reports of family trauma due to personality changes and otherwise unexplained suicides indicate that many questions have yet to be answered about the full range of effects highly targeted synthetic chemicals have on our overall health. No wonder more and more people are looking to time-tested dietary and herbal prevention and remedies.


Resources:

http://news.yahoo.com/s/ap/20080831/ap_on_go_ot/med_drugs_suicide;_ylt=Agwvy5wwqd1PsPIQTaxNEEKs0NUE

http://news.yahoo.com/s/ap/20080831/ap_on_go_ot/med_drugs_suicide_list_1

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