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New test predicts suicide risk in patients on antidepressants


December 18, 2013

A new test has been developed that could help identify patients using antidepressants who are at risk of treatment-emergent suicidal ideation (Photo: Max Planck Institute of Psychiatry)

A new test has been developed that could help identify patients using antidepressants who are at risk of treatment-emergent suicidal ideation (Photo: Max Planck Institute of Psychiatry)

The results of a years-long study with patients on antidepressants may help doctors predict one of the most severe side effects those medications can produce: treatment-emergent suicidal ideation (TESI). The condition is estimated to affect between four and 14 percent of patients, who typically present symptoms of TESI in the first weeks of treatment or following dosage adjustments. So far doctors haven’t had indicators to predict which patients are more likely to develop TESI, but a new test based on research carried out by the Max Planck Institute of Psychiatry in Munich, Germany, could change that.

The researchers carried out genome-wide association studies on 397 patients aged 18 to 75 who were hospitalized for depression, but were not experiencing suicidal ideation at the time they began treatment. These kinds of studies scan a range of common genetic variables to find differences between groups of people. In this case the aim was to detect who was a TESI risk and who wasn't.

During the study, a reported 8.1 percent of patients developed TESI, and 59 percent of those developed it within the first two weeks of treatment. The researchers used the suicide item 3 of the Hamilton Rating Scale for Depression to evaluate TESI.

To arrive at a list of reliable predictors, the team genotyped the whole group and then compared patients who developed TESI with those who didn’t. By doing this they found a subset of 79 genetic variants associated with the risk group. These 79 genetic markers were then analyzed in a larger independent sample of in-patients suffering from depression, and could classify more than 90 percent of the patients correctly.

The research also sheds new light on the age of those affected by TESI. Prior to discovering that all age groups in the study were at risk, the assumption had been that under-25s were more at risk, which in 2005 prompted the US Food and Drug Administration to start issuing a black box warning. Some experts say the warning led to a decrease in drug-based treatment, a situation that could be reversed now that doctors can avail themselves of a new assessment tool based on the research.

The laboratory developed test, featuring a DNA microarray (chip), is being launched immediately by US company Sundance Diagnostics, ahead of submission to the US Food and Drug Administration for market clearance.

"A DNA microarray is a small solid support, usually a membrane or glass slide, on which sequences of DNA are fixed in an orderly arrangement," Sundance CEO Kim Bechthold tells Gizmag. "It is used for rapid surveys of the presence of many genes simultaneously, as the sequences contained on a single microarray can number in the thousands."

"Our hope is that the new test will assist the physician in significantly reducing the risk of suicide emerging from antidepressant drug use and will provide patients and families with valuable personal information to use with their doctors in weighing the risks and benefits of the medications," Bechttold said in a press statement.

Source: Max Planck Institute of Psychiatry

About the Author
Antonio Pasolini Brazilian-Italian Antonio Pasolini graduated in journalism in Brazil before heading out to London for an MA in film and television studies. He fell in love with the city and spent 13 years there as a film reviewer before settling back in Brazil. Antonio's passion for green issues - and the outdoors - eventually got the best of him and since 2007 he's been writing about alternative energy, sustainability and new technology. All articles by Antonio Pasolini

This is scumbaggery at its finest. No one should be on antidepressants at all ever. Doctors should not under any circumstances be relieved of their responsibility to people. And companies like this think there is value in helping to get more SSRIs to the population smoothly are seriously misdirected.

In English the term treatment-emergent suicidal ideation (TESI) means that some people get murderous rages where concern for themselves or others is gone. SSRI is lobotomy for empathy. Think that'll fix your depression?

If you spent this time and effort into looking to causes it just might save you me and the rest of humanity. Patching up a buggy program won't help anyone.


sugamari ...thank you for your excellent comment. If you have not already posted I would have to write here something very similar but you did a much better job.

Nobody ever should be put on antidepressants. They have little if any effect at all if compared to placebo. There have been many books written on the subject, for instance: The Emperor's New Drugs: Exploding the Antidepressant Myth by Irving Kirsch, a Harvard professor.


Sugamari, I do agree with you about some aspects, I think that the medical profession is vey disengaged from mental illness and a lot of GPs (and even some specialists) don't understand what depression even is. (we all know that look of 'yeah get over it' when we try to explain what is essentially impossible to articulate to anyone who has not been afflicted), however, once i found the correct medication, i did feel better (all be it numb). To those who just don't understand, depression is very real and very cruel.. Trying to ask a depressed person to 'cheer up is like asking someone who downed a litre of whiskey to just 'sober up'.. we are talking about almost the same thing actually, except alcohol causes a chemical imbalance by an introduced means and can be switched off, but depression is an imbalance caused by something physically wrong in the brain. At the end of the day, SSRI only mask the problem (not too well either), the real 'structural' root cause is not even close to being revealed.

Simon Sammut

".....Heinrichs said Friday the use of Prozac resulted in "unique circumstances" he was forced to consider. He described how the killer went from a loving, happy-go-lucky kid to a dark, depressed drug abuser. The accused began to act out violently and even tried to harm himself on several occasions. Heinrichs said it's clear the boy's parents did the right thing in taking their concerns to his various doctors, but they were largely ignored as the Prozac dosage was only increased."

...hope for the best...pushing the drugs, now "safely" again.

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