New study provides perspective on FDA warning for antidepressants.新的研究角度提供关于美国FDA警告抗忧郁药物.

Group Health - In a NIMH-funded study of more than 100,000 patients treated for depression, suicide attempts declined during the first month of treatment - whether that treatment consisted of medication, psychotherapy, or both.健康组,在一个用NiMH资助的研究达10余万患者接受治疗抑郁症自杀死亡率下降,在第一个月的治疗,无论是治疗包括药物治疗,心理治疗,或两者兼而有之. The findings, published by Group Health researchers in the July 2007 American Journal of Psychiatry , show a similar pattern for populations of adolescents and young adults (up to age 24) as for older adults.结果,公布卫生组研究人员在2007年7月美国杂志精神病显示出类似的格局种群青少年和年轻成人(24岁)为老年人.

The study sheds new light on the “black box” advisory that the U.S. Food and Drug Administration (FDA) placed in 2004 on antidepressants and has revised since then, said Greg Simon, MD, MPH, the Group Health psychiatrist who led the study.这项研究使人们对"黑匣子"的顾问,美国食品和药物管理局(FDA)于2004抗抑郁药物,并已修订此后,议员Greg说,西门,海事,公共卫生,77健康精神科医师为首的研究. The advisory - which has concerned many patients, families, and care providers - warns that suicidal behavior may emerge soon after people younger than 25 start treatment with newer antidepressant medications called selective serotonin reuptake inhibitors (SSRIs).咨询--它已涉及到许多病人,家属和关怀提供商-警告说,自杀行为可能出现不久,人们在25岁以上开始治疗新车抗抑郁药物称为选择性血清素再吸收抑制剂(SSRIs和). It was spurred by randomized placebo-controlled trials showing that starting to take an SSRI can make thoughts of suicide more common among some teens and young adults.它带动的随机安慰剂对照临床试验显示起采取一种药可以使思想更加自杀常见一些青少年和年轻成人.

Dr. Simon’s study is the first published research to compare the risk of suicide attempts before and after the start of treatment with not only antidepressants but also psychotherapy.西门博士的研究是第一次发表的研究比较危险企图自杀前和开始后,治疗不仅抗抑郁药,但也一蹶不振. It is based on computerized medical and pharmacy records for more than 109,000 patients who started treatment for depression at Group Health from 1996 to 2005.它是基于计算机医学和药学的记录超过109,000病人开始治疗抑郁症健康组,从1996年至2005年.

In the study, suicide attempts were about twice as common among patients up to age 24 as among older adults.在研究自杀未遂者的两倍作为普通患者到24岁之间的老年人. However, the time pattern was the same for both age groups, regardless of the type of treatment they received: Suicide attempts were most likely during the month before treatment started, falling by at least 50 percent in the month after treatment began, with steady declines thereafter.不过,当时的模式是一样的,为这两个年龄组中,不论何种类型的治疗,他们收到:企图自杀者最有可能在一个月前开始治疗,下降了至少50%,在一个月后开始治疗,以平稳下降.

At all time points - up to three months before and six months after starting treatment - patients who received their antidepressant prescription from a psychiatrist tended to be most likely to attempt suicide.在所有时间点上升至前3个月和6个月后开始治疗的病人接到其抗抑郁药处方,由精神科医生往往是最容易自杀. Those who received it from their primary care doctor were least likely to attempt suicide, with levels in between for those who got individual psychotherapy from a therapist other than a psychiatrist.那些收到来自他们的初级保健医生是最可能试图自杀同层次之间,为那些有个别心理治疗,从治疗以外的一种精神病. “That’s not because seeing a psychiatrist makes you want to kill yourself,” said Dr. Simon."那不是因为看见一名精神病让你想杀死你,"博士说西蒙. Rather, he suggested, these results reflect the fact that people with severe depression, who tend to be more suicidal, are more likely to be referred to psychiatrists, while those with milder depression stick with their primary doctors.相反,他认为,这些结果反映出患有严重抑郁症,他们往往会更自杀,更有可能被转介到精神科医生,而那些轻度抑郁坚持自己的基层医生.

“Our study indicates that there’s nothing specific to antidepressant medications that would either make large populations of people with depression start trying to kill themselves - or protect them from suicidal thoughts,” said Dr. Simon."我们的研究显示,有什么具体的抗忧郁药物,要么使大量人口患有抑郁症开始尝试去送命或保护他们免遭自杀念头,"博士说西蒙. “Instead, we think that, on average, starting any type of treatment - medication, psychotherapy, or both - helps most people of any age have fewer symptoms of depression, including thinking about suicide and attempting it.” That said, he likened population-based studies - both observational studies such as this one and randomized controlled trials of medications - to “circumstantial evidence” about what happens to individual patients."相反,我们认为,平均来说,从任何类型的治疗药物,心理治疗,或两者都有利于最广大人民的,任何年龄都较少忧郁的症状中,包括思考和自杀企图."说,他比喻人口为基础的研究,包括观测研究,像这样的一个随机对照试验的药品-"间接证据",什么情况下对个别病人.

Like other psychiatrists, Dr. Simon has seen a few depressed patients start having suicidal thoughts while taking antidepressant medication despite never having thought about suicide before then.像其他精神病西门博士已经看到少数抑郁症患者开始有自杀的念头,同时抗抑郁药尽管从来没有思考关于自杀前. He hypothesizes that subgroups of people may be vulnerable to becoming more agitated or suicidal after taking these drugs.他假设群的人可能容易变得激动或自杀后,服用这些药物. “We hope to learn how to identify these people in advance,” he said."我们希望能学习如何找出这些人的推进,"他说.

Dr. Simon published an earlier paper showing that the risk of suicide attempts decreased in the weeks after patients started taking antidepressant medication.西蒙博士发表了早先一份文件显示,自杀的危险性下降,企图在今后几个星期后,病人开始以抗抑郁药物. His new study strengthens his earlier conclusion that for populations of people, even teens and young adults, suicide attempts tend to be rarer right after starting antidepressant medication than beforehand.他的新研究更增强了他早先的结论,即种群的人,即使是十几岁和年轻成人,自杀往往是罕见权后,开始抗抑郁药不是事前. He echoed the FDA’s recommendations that doctors regularly monitor their patients during treatment with antidepressants to ensure that they are receiving the right medication at a dose that helps them feel better.他呼应了FDA的建议,医生定期监测患者治疗期间的抗忧郁剂,以确保它们接收正确的,在服药剂量,从而帮助他们感觉更好. “If people feel agitated or suicidal, they should seek help from a doctor or therapist,” he added (Courtesy of EurekAlert!, a service of AAAS)."如果人们感到激动或自杀,他们应该求助医师或治疗师那里,他补充说:"(礼貌eurekalert!,服务促会).