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 Use of Sertraline Linked to Suicidality LONDON, May 30 (Reuters Health) - The use of sertraline might prompt some patients to commit suicide, a UK researcher warns based on a study of healthy volunteers. In a double-blind, randomized crossover study, Dr. David Healy of the University of Wales College of Medicine compared the effects of two selective serotonin reuptake inhibitors (SSRIs) in 20 individuals, ages 28 to 52, who had no history of psychiatric illness. The study aimed to monitor the effects of the drugs on the state of well being and "in particular the serenic effect that appears associated with the use of SSRIs," Dr. Healy writes in the June issue of Primary Care Psychiatry. Subjects received either reboxetine (marketed as Edronax in the UK and as Vestra in the US), 4 mg q.d. for 5 days and increased to 4 mg b.i.d. if tolerated, or sertraline (Zoloft), 50 mg q.d. for 5 days, increased to 100 mg b.i.d. if tolerated. Treatment lasted for a total of 2 weeks, followed by a 2-week washout period and then crossover to the opposite arm. None of the subjects had suicidal ideation on reboxetine although two reported depression, Dr. Healy found. "In contrast, two developed suicidal thoughts on sertraline," he writes. Within a few days of treatment both of these patients reported feeling restless and "fidgety." There is "no easy means of explaining what happened other than by invoking an SSRI-induced suicidality," Dr. Nealy writes. "The mechanism...appears to have been a combination of akathisia and emotional blunting, as well as other features suggestive of an automatism." He points out that the risk of drug-induced problems in nondepressed volunteers is of concern because "antidepressants are commonly prescribed for stress reactions." Prim Care Psychiatry 2000;6:25-28.
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