I was looking at Sertraline (T-H-L-K-D) (a Featured Article, by the way) on Wikipedia. According to Wikipedia, antidepressants like Zoloft tend to lead to suicide. At least, that's what I got from reading the first paragraph.

Specifically:



I guess suicide is a way of ending depression and anxiety?

Gulp.

Edit: Changed "Zoloft" to its scientific name "Setraline" in post. History, logs, etc. tags were going to the wrong article.

It is all too sadly true. Indeed, I wouldn't read this post of mine too many times.

Imagine someone with anxiety looking on the Internet for anti-anxiety/anti-depressant medication, Googling "Zoloft," finding the Wikipedia article on it, and seeing for all intents and purposes "may increase chances of suicide" in the first paragraph. Wikipedia "may increase chances of higher anxiety" should be a disclaimer on the doggone main page! Anti-depressants make people more suicidal than less!?! The cure is worse than the problem, if what Wikipedia says is true!

Between Zoloft and Coffee, this site is encouraging dangerous addictions!

Coffee -> Caffeine -> Increase in higher anxiety -> Zoloft -> Suicide

My guess would be that a group of anti-psychiatric/anti-pharma editors got together and insisted on that wording and placement - if someone were to go back over the revisions, they'd probably find an edit war or three over it. The Scientologists might have had a hand in that too, since they're big on bashing psychiatrists and drug companies. (Cuts into their profits!)

We actually had one or two anti-pharma people join WR at one point, though I don't think either of them were CoS - they didn't participate much, and we haven't heard from them recently...

The article does explain in more detail down the line about Zoloft and suicide.

http://en.wikipedia.org/wiki/Sertraline#Suicidality

Suicidal tendencies increase in adults aged 18 through 24 as well as with children and teenagers on Zoloft. But the lead makes it sound like suicidal tendencies increase for everyone on Zoloft. It's very confusing. Is there an increase in suicidal tendencies or not? It's a mixed message to me.

I'd go to medical professional or a website maintained by medical professionals to get a better, accurate answer. However, for a lot of people, Wikipedia is the first and last stop on learning anything.

Increased risk of suicide in the first few weeks of antidepressant treatment is well documented. The argument is that very depressed individuals are too depressed to act on ending their lives, but when the antidepressant effect of medication begins to take effect, they are still depressed but find themselves with enough drive to carry out the act. Individuals find themselves not only motivated, but with the means at hand. Many antidepressants are extremely toxic in overdose.

Well, you'd get the same impression looking at a box of Zoloft, which carries a big honking warning saying more or less the same thing.

Antidepressants are tricky, because different medications and doses can have wildly different effects on different people. (Confusing things more, the pharmaceutical companies continue to create and market newer antidepressants, presumably because they can't reap record profits on stalwarts like Zoloft and Prozac for which the patents have expired.) Finding the right drug can be tricky, and the period when you're being weaned onto the drug may increase depression for a period before kicking in properly. So it's hard to tell whether the drugs themselves are increasing a patient's suicidal thoughts, or if the drug just isn't effective enough for them and they're having the same suicidal thoughts they'd be having with no medication.

So, presumably these vague blanket warnings are there to cover the companies' tuckuses. For example, in 1999 the family of Phil Hartman's wife tried to sue the makers of Zoloft and the psychiatrist who prescribed it to her shortly before her murder-suicide. Never mind that she was soused and high on cocaine at the time of the act; some people are just sue-happy.

It is true. Many antidepressants make you feel worse for a while before making you feel better, and increased suicidality (especially in younger patients) is known. See also paradoxical reaction (T-H-L-K-D).

Possibly the most important thing to know about anti-depressants is that they increase the risk, at least short-term, of suicide. It's important to know this in order to guard against the risk.

No, I'm not an SPA here to push my POV on medication. I picked this name and av because my dear departed mother used to refer to me as 'a little pill.' In England at that time that was a slang term for a somewhat irritating juvenile. Which I was.

They should have hired Unfrozen Caveman Lawyer for that job. Oh, wait...

It seems to be fairly clear that the most dangerous antidepressants are the ones with the short half-lives that hit hard, at first. Things like Paxil. Also, drugs that have extra-serotenergic properties that make people irritable and trigger-happy, don't seem like the best thing to take at the same time patients are trying to survive phase I of antidepressant meds, and not shoot themselves. And during which, the only thing making them feel better is the placebo effect from the fact that they're finally under treatment (the drug itself is either doing nothing, or making them feel worse, for at least 3 weeks).

Many of the old wise shrinks have stuck with the old selective and long acting SSRIs like Celexa and Prozac for initial treatment. And are liberal about addictive anti-anxiety and pain drugs like benzos and narcotics, for the month or two it takes for the others to act. Obviously the pharm companies don't support this. Right now they're telling doctors that Paxil does bad things to teenagers that it doesn't do to adults. And how likely is that? Just a priori? And yes, the evidence to support it is not that good. But if Paxil was a risk to EVERYONE they'd have to take it off the market, and we can't have that.

Could be her way of saying you didn't do her a bit of good.

Oh, I would agree. She was droll but accurate.

Well, I won't dispute that anti-depressants can cause suicidal tendencies. I still think that the lead of the article could be reworded to make it less scary.

I did see that there was a slow moving edit war on the article in December 2009 between The Sceptical Chymist (T-C-L-K-R-D) and Editor182 (T-C-L-K-R-D) . The Sceptical Chymist has been accused by others of being an anti-anti-depressant advocate, notably by Literaturegeek (T-C-L-K-R-D) in June 2009. I can see why people might be concerned about any edits of his on anti-depressant articles.

I guess the risk of possible suicidal tendencies is well worth it compared to a life-time of crippling depression.

Besides, it's worth for the drugs I need!

Undoubtedly, but some of these drugs are more dangerous than others. In the US, people don't always get started on the least dangerous, most side-effect free, and most tried-and-true ones first. Because many of those are generic. Instead, they get whatever free samples the drug rep last left in the doctors' office. Which means something new and still on-patent. The doctor makes no money for this, so it's not as corrupt as it could be. But on the other hand, it's biased in favor of what Wikipedia would call "recentism."

Sir William Osler to a student doctor: "Use the new drugs quickly, young man, before they lose their effectiveness."

Since suicide has been mentioned, I've claimed that there have likely been suicides triggered by abusive Wikipedia process (or lack of protective process), and this was pooh-poohed.

I was just reading a history of the W.E.L.L., and it happened early on with that on-line community. It would be astonishing if it didn't happen with the much larger (and, in reality, more abusive, because of different reasonable expectations) Wikipedia community.

(I was there for a couple of years of that early history, and was one of the users who befriended Mark Ethan Smith -- I actually attended a court hearing for a case that had been filed -- and was then savaged as described. MES, indeed, scribbled much of her/his contributions as a result of my writing, because when s/he determined that I was Yet Another Abuser, s/he attempted to delete all my contributions to his/her conferences, saw that this made complete mincemeat of them, due to massive quotation by others, so the conferences themselves were deleted, removing months of his/her own work.)

I first saw, on the W.E.L.L, the frustrating situation where a community of on-line users steadfastly promotes its own impression of what had happened in some dispute, when simply reading the record, which was, for the first time, completely available, would result in a very different impression. Someone would complain about being abused. Others would react to the complaint as if it was the problem, without checking. Sometimes this reaction is appropriate, quite possibly most of the time. But when it's not, it's a killer, because the complainer then becomes completely frustrated and normally becomes even more assertive and therefore even more irritating to those who dislike complaints and it all spins out. And if I'd actually read the history and then dared to defend the complainant, I was "defending a disruptive user" who is being "uncivil" and who is obviously "obsessed." So now I was also a problem. Never got banned there, though, very few were banned.

It all goes way back, folks, there is nothing new under the sun, not really.