抗抑郁药物与自杀
抗抑郁药会引起自杀是真的吗?我曾经向精神科医生请教过这个问题。以下是专业的解释。
据临床观察,抑郁症服药自杀多发生于重度抑郁症刚开始服药时。重度抑郁的患者有自杀念头,但是因为抑郁严重,使他们没有精神、体力去执行自杀的行动。当药物开始缓解抑郁症状时,患者首先在精力上有了进步,比以前有活力。此时,有些患者的自杀念头还没有消失。但由于精力的恢复,使这些患者有体力去计划、实施自杀行动。目前没有证据表明抗抑郁药会增加自杀的念头。换句话说,没有自杀想法的人,服用抗抑郁药,不会增加自杀的风险。所以,有自杀念头的重度抑郁患者,在用药早期,需要密切随访、评估自杀风险,加强看护,直到病情平稳。
下面是一些抑郁与自杀的数据。可以看出自杀最首要的原因是还是抑郁症本身没有得到控制。
抑郁与自杀
- 每2例他杀发生时,就有3例自杀发生。美国每年有30,000起有案可查的自杀。其中,逾2/3是由抑郁症引起的。(1998,美国老年协会;1999,白宫)
- 老年人的自杀率比全国平均水平高50%。老年人自杀的原因,其2/3归咎于抑郁症未被治疗或被误诊。(1998,美国老年协会)
- 年轻人自杀的首位原因就是抑郁症没有得到治疗。在15-24岁和10-14岁青少年的死亡原因里,自杀分别是第三、第四位的。15-24岁的男性有更高的自杀风险。因为同龄男女性自杀比例是7:1。(1996,美国自杀学协会)
数据来源:Depression Statistics/Depression and Suicide
- Depression is the cause of over two-thirds of the 30,000 reported suicides in the U.S. each year. (White House Conference on Mental Health, 1999)
- For every two homicides committed in the United States, there are three suicides. The suicide rate for older adults is more than 50% higher than the rate for the nation as a whole. Up to two-thirds of older adult suicides are attributed to untreated or misdiagnosed depression. (American Society on Aging, 1998)
- Untreated depression is the number one risk for suicide among youth. Suicide is the third leading cause of death in 15 to 24 year olds and the fourth leading cause of death in 10 to 14 year olds. Young males age 15 to 24 are at highest risk for suicide, with a ratio of males to females at 7:1. (American Association of Suicidology, 1996)
- The death rate from suicide (11.3 per 100,000 population) remains higher than the death rate for chronic liver disease, Alzheimer’s, homicide, arteriosclerosis or hypertension. (Deaths: Final Data for 1998, Center for Disease Control)