Suicidal Thoughts May Vary by Antidepressant

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Men face higher risk when taking nortriptyline than escitalopram, study finds

THURSDAY, Oct. 15 (HealthDay News) -- Men who take the antidepressant nortriptyline (Aventyl) are nearly 10 times more likely to have suicidal thoughts than those who use the antidepressant escitalopram (Lexapro, Cipralex), a new study has found.

The study, published online Oct. 15 in BMC Medicine, included 811 people with moderate to severe unipolar depression. Though it found an overall reduction in suicidal thoughts, men who took nortriptyline were found to have a 9.8-fold increase in emerging suicidal thoughts and a 2.4-fold increase in worsening suicidal thoughts, compared with those who took escitalopram.

"Our findings that treatment-emerging and worsening suicidal thoughts may also be associated with psychomotor activation triggered by antidepressants need to be investigated in future studies," the study team's leader, Dr. Nader Perroud, from the Institute of Psychiatry at King's College London, said in a news release from the journal's publisher.

"The study also refutes the idea that newer antidepressants such as the SSRIs [selective serotonin reuptake inhibitors] are worse than older medications in terms of increasing suicidal thoughts," Perroud added.

Nortriptyline is a tricyclic antidepressant that inhibits the reuptake of noradrenaline and, to a lesser degree, that of serotonin, according to background information in the news release. Escitalopram is an SSRI.

More information

The U.S. Agency for Healthcare Research and Quality has more about antidepressants.


-- Robert Preidt
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