NCPA - National Center for Policy Analysis


November 29, 2007

Selective serotonin reuptake inhibitors (SSRIs) - a class of anti-depressants -- are among the most widely prescribed -- and debated -- medications in the world, but new research does indicate that they are successful in reducing the risk of suicide, say the authors of a National Bureau of Economic Research Working Paper.

According to the authors:

  • In general, an increase in SSRI sales of one pill per person per year -- about a 12 percent increase over year 2000 sales levels -- is associated with a decrease in deaths from suicide of about 5 percent.
  • Now that SSRIs are off patent, spending an additional $20,000 on them in the United States could avert one death from suicide.
  • That is a cost per life saved far below the cost of most other public health or regulatory government intervention.

Despite clinical evidence that antidepressant use may increase the risk of non-lethal suicidal behavior in pediatric patients, the authors find that the protective effect of SSRI sales on suicide mortality is largest, in both proportional and absolute terms, for people aged 15-24.

These estimates of SSRI effects improve on those from randomized clinical trials (RCTs).  Although RCTs are the "gold standard" for the study of treatment effectiveness in the medical literature, they have important limitations, such as sample sizes that are too small and the fact that people at high risk for suicide are often excluded from trials for ethical reasons, say the authors.

Source: Linda Gorman, "Anti-Depressants Reduce Suicide," NBER Digest, November 2007; based upon: Jens Ludwig, Dave E. Marcotte and Karen Norberg, "Anti-Depressants and Suicide," Working Paper No. 12906, National Bureau of Economic Research, February 2007.

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