Suicidality and fluoxetine: is there a relationship?

J Clin Psychiatry. 1991 Mar;52(3):108-11.

Abstract

A recent report of six depressed patients who developed intense, violent suicidal preoccupation after 2 to 7 weeks of fluoxetine treatment prompted the authors to survey 27 psychiatrists who treated 1017 depressed outpatient with antidepressants during 1989: 3.5% (8/231) of those treated with fluoxetine alone, 6.5% (4/62) of those treated with fluoxetine and tricyclics, 1.3% (5/385) of those treated with tricyclics alone or with lithium, and 3.0% (3/101) of those treated with other antidepressants became suicidal only after treatment with these antidepressants was initiated. None of these patients, however, reported intense suicidal thoughts of the degree described in the previously reported six cases. The difference in incidence of suicidal ideation occurring only after initiation of treatment was not significant between patients treated with fluoxetine alone and those receiving the other antidepressant treatments.

MeSH terms

  • Ambulatory Care
  • Antidepressive Agents, Tricyclic / adverse effects
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / psychology
  • Drug Therapy, Combination
  • Fluoxetine / adverse effects*
  • Fluoxetine / therapeutic use
  • Humans
  • Lithium / adverse effects
  • Lithium / therapeutic use
  • Monoamine Oxidase Inhibitors / adverse effects
  • Monoamine Oxidase Inhibitors / therapeutic use
  • Retrospective Studies
  • Suicide / psychology*
  • Suicide / statistics & numerical data
  • Surveys and Questionnaires

Substances

  • Antidepressive Agents, Tricyclic
  • Monoamine Oxidase Inhibitors
  • Fluoxetine
  • Lithium