A review of trials of antidepressants taken by healthy adults with no signs of a mental health disorder has found the drugs used to treat the illness doubled the harms related to suicide and violence.

Experts working on the study said the analysis was undertaken because the harms of antidepressants, including the risk of suicide, are often explained away as if they are disease symptoms or only a problem in children.

Professor Peter Gøtzsche, of the Nordic Cochrane Centre and lead author of the study, said: "While it is now generally accepted that antidepressants increase the risk of suicide and violence in children and adolescents, most people believe that these drugs are not dangerous for adults.

"This is a potentially lethal misconception."

He added: "The reporting of harms in drug trials is generally poor.

"Our review established that the trials did not report much about their methodology and that the reporting of adverse events was generally inadequate."

Thirteen double-blind, placebo-controlled trials were included in the review by the research team from the Nordic Cochrane Centre and the University of Copenhagen.

The researchers believe that the review even 'underestimates the harms of antidepressants' since they had access to only the published articles for 11 of the 13 trials, rather than being able to analyse the full data held by the drug companies.

Professor Gøtzsche added: "It is well documented that drug companies under-report seriously the harms of antidepressants related to suicide and violence, either by simply omitting them from reports, by calling them something else or by committing scientific misconduct."

However, Professor Sir Simon Wessely, President of the Royal College of Psychiatrists and Professor of Psychological Medicine, King's College London's Institute of Psychiatry, Psychology and Neuroscience, said the study 'changes nothing'.

"This paper shows that antidepressants have side effects such as odd dreams, nervousness and shaking. This is very familiar to most, if not all, clinicians.

"But importantly, no data presented in the paper supports extrapolating from these side-effects to self-harm and violence.

Comment: But there is a good deal of evidence from other sources showing links between antidepressant use, violence and suicide:
SSRI antidepressants: Putting patients at clear risk of suicide

Dr. David Healy, professor of psychiatry at Bangor University estimates as many as 1,000 to 2,000 Americans on SSRIs kill themselves each year, when they otherwise would not have done so. Violent acts against others and birth defects are also linked to the pills. In 1997, drug safety activists launched a website called, which archived credible and published reports that cite the role of SSRIs and related antidepressants in suicides and other violent behavior.

There are now thousands of entries. "The kind of energy, rage and insanity seen in a lot of crimes today was not seen before SSRIs appeared," said Rosie Meysenburg, a founder of the website in an interview shortly before her death.

In addition to the thousands of suicides, "there are two cases of women on the SSRI Stories site who stab a man close to 200 times and a case of a man who stabs his wife over 100 times and then goes next door to the neighbor's house and stabbed the neighbor's furniture about 500 times."

The SSRI stories archive includes people on SSRIs setting themselves on fire, violent elderly people (which is rare) and bizarre cases of kleptomania and female school teachers molesting their minor male students. The common denominator in all the recorded crimes is the drug.

"The strongest conclusion one can draw from this data is to say that some symptoms such as agitation occur in depression itself and in response to antidepressants, and that sometimes these symptoms are also experienced by people who go on to commit acts of violence or self-harm.

"Overall, medications used in any branch of medicine that do good can also do harm. The same applies in psychiatry.

"Current evidence from large scale studies continues to show that for antidepressants the benefits outweigh the risks. If the evidence changes then so will our advice, but this study changes nothing."

Comment: A study published in The New England Journal of Medicine found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit - but almost none of the studies that show these drugs are ineffective, leading people to think that they do work.

Dr David Christmas, Member of the Psychopharmacology Committee, Royal College of Psychiatrists and Consultant Psychiatrist in The Advanced Interventions Service, Dundee, said the study is not suitable to answer the questions researchers wanted to ask.

He said: "Most of the trials reported varied in the type of drug used, the dose, duration and the mechanisms of reporting harms.

"Importantly, the study only identified emergent harms that are associated (directly or indirectly) with suicide and violence.

"It didn't identify a higher rate of these outcomes from the studies they used."

The study was published today by the Journal of the Royal Society of Medicine.

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