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选择性5-羟色胺再摄取抑制剂与自杀行为：合理的说法？

Suicidality with selective serotonin reuptake inhibitors: Valid claim?

作者信息

Lapierre Yvon D

机构信息

Journal of Psychiatry & Neuroscience.

出版信息

J Psychiatry Neurosci. 2003 Sep;28(5):340-7.

PMID:14517577
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC193980/
Abstract

The red flags raised by the 1990 clinical reports of increased suicidality associated with treatment with the selective serotonin reuptake inhibitor (SSRI) fluoxetine were followed by anecdotal reports of similar symptoms with other antidepressants of the same class. Recent discussions by Healy have argued in favour of a suicidogenic potential of the SSRIs. This paper reviews the relevant literature addressing the epidemiological data of Western populations and the data accumulated from clinical trial databases in several countries. The evidence currently available does not support the hypothesis that antidepressants or, more specifically, SSRIs cause increased suicidality in patients with depression, nor do they appear to do so in patients treated with these drugs for other reasons.

摘要

1990年的临床报告指出，选择性5-羟色胺再摄取抑制剂（SSRI）氟西汀治疗会增加自杀倾向，这引发了警示信号，随后有轶事报道称，同一类别的其他抗抑郁药也有类似症状。希利最近的讨论支持了SSRI具有潜在自杀诱导作用的观点。本文回顾了相关文献，涉及西方人群的流行病学数据以及几个国家临床试验数据库积累的数据。目前可得的证据并不支持抗抑郁药，更具体地说是SSRI会导致抑郁症患者自杀倾向增加这一假说，而且在因其他原因使用这些药物治疗的患者中似乎也并非如此。

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Suicidality with selective serotonin reuptake inhibitors: Valid claim?选择性5-羟色胺再摄取抑制剂与自杀行为：合理的说法？
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2
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[Selective serotonin reuptake inhibitors in major depressive disorder in children and adolescents (ratio of benefits/risks)].[儿童和青少年重度抑郁症中选择性5-羟色胺再摄取抑制剂（获益/风险比）]
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引用本文的文献

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J Psychiatr Res. 2013 Sep;47(9):1199-203. doi: 10.1016/j.jpsychires.2013.05.025. Epub 2013 Jun 17.
2
Suicidal ideation reports from pediatric trials for paroxetine and venlafaxine.帕罗西汀和文拉法辛儿科试验中的自杀意念报告。
Can Child Adolesc Psychiatr Rev. 2003 Nov;12(4):101-2.
3
Do SSRIs or antidepressants in general increase suicidality? WPA Section on Pharmacopsychiatry: consensus statement.一般来说，选择性5-羟色胺再摄取抑制剂（SSRI）或抗抑郁药会增加自杀倾向吗？世界精神病学协会药物精神病学分会：共识声明。
Eur Arch Psychiatry Clin Neurosci. 2008 Aug;258 Suppl 3:3-23. doi: 10.1007/s00406-008-3002-1.
4
Duloxetine and suicide attempts: a possible relation.度洛西汀与自杀未遂：一种可能的关系。
Clin Pract Epidemiol Ment Health. 2008 Jun 11;4:18. doi: 10.1186/1745-0179-4-18.
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Increase in US youth suicide rates 2004.2004年美国青少年自杀率上升。
Inj Prev. 2008 Feb;14(1):2-3. doi: 10.1136/ip.2007.017772.
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Drinking frequency and quantity and risk of suicide among men.男性的饮酒频率、饮酒量与自杀风险
Soc Psychiatry Psychiatr Epidemiol. 2007 Feb;42(2):153-60. doi: 10.1007/s00127-006-0144-1. Epub 2007 Jan 17.
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Is there evidence for negative effects of antidepressants on suicidality in depressive patients? A systematic review.抗抑郁药对抑郁症患者自杀倾向有负面影响的证据存在吗？一项系统综述。
Eur Arch Psychiatry Clin Neurosci. 2006 Dec;256(8):476-96. doi: 10.1007/s00406-006-0689-8. Epub 2006 Dec 1.
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Suicide attempts in clinical trials with paroxetine randomised against placebo.在帕罗西汀与安慰剂对照的临床试验中的自杀未遂情况。
BMC Med. 2005 Aug 22;3:14. doi: 10.1186/1741-7015-3-14.
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Use of selective serotonin reuptake inhibitors in children and adolescents.选择性5-羟色胺再摄取抑制剂在儿童及青少年中的应用。
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本文引用的文献

1
Antidepressants and suicide: risk-benefit conundrums.抗抑郁药与自杀：风险-效益难题
J Psychiatry Neurosci. 2003 Sep;28(5):331-7.
2
Are placebo controls necessary to test new antidepressants and anxiolytics?测试新型抗抑郁药和抗焦虑药是否需要安慰剂对照？
Int J Neuropsychopharmacol. 2002 Sep;5(3):193-7. doi: 10.1017/S1461145702002912.
3
Adequacy of antidepressant treatment after discharge and the occurrence of suicidal acts in major depression: a prospective study.出院后抗抑郁治疗的充分性与重度抑郁症患者自杀行为的发生：一项前瞻性研究。
Am J Psychiatry. 2002 Oct;159(10):1746-51. doi: 10.1176/appi.ajp.159.10.1746.
4
Mortality of patients with mood disorders: follow-up over 34-38 years.情绪障碍患者的死亡率：34至38年的随访
J Affect Disord. 2002 Apr;68(2-3):167-81. doi: 10.1016/s0165-0327(01)00377-9.
5
Improvements in the recognition and treatment of depression and decreasing suicide rates.抑郁症识别与治疗方面的改善以及自杀率的下降。
N Z Med J. 2001 Dec 14;114(1145):535-6.
6
Suicide risk in placebo-controlled studies of major depression.重度抑郁症安慰剂对照研究中的自杀风险。
Am J Psychiatry. 2001 Aug;158(8):1271-5. doi: 10.1176/appi.ajp.158.8.1271.
7
Symptom reduction and suicide risk in patients treated with placebo in antidepressant clinical trials: a replication analysis of the Food and Drug Administration Database.抗抑郁临床试验中接受安慰剂治疗患者的症状减轻与自杀风险：食品药品监督管理局数据库的重复分析
Int J Neuropsychopharmacol. 2001 Jun;4(2):113-8. doi: 10.1017/S1461145701002322.
8
Antidepressants and suicide.抗抑郁药与自杀
Aust N Z J Psychiatry. 2000 Feb;34(1):168. doi: 10.1080/000486700370.
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Suicide prevention--a medical breakthrough?自杀预防——一项医学突破？
Acta Psychiatr Scand. 2000 Aug;102(2):113-7. doi: 10.1034/j.1600-0447.2000.102002113.x.
10
Risk of suicidality in depression with serotonergic antidepressants.使用血清素能抗抑郁药治疗抑郁症时的自杀风险。
Ann Clin Psychiatry. 2000 Mar;12(1):43-50. doi: 10.1023/a:1009027010991.