Psychiatrists are unsure whether a modern class of anti-depressants might induce suicide in some patients, a poll taken at the a.g.m. of the Irish Division of the Royal College of Psychiatrists suggests.
The vote took place yesterday after a debate on the motion: "This house believes there is a causal link between suicide and selective serotonin re-uptake inhibitors (SSRIs)".
Dr David Healy, director of the north Wales department of psychological medicine at the University of Wales, spoke in favour.
Prof Patricia Casey and Prof Kevin Malone, both of the department of psychiatry at University College Dublin, opposed the motion.
Prior to the debate a majority of those present voted against the motion suggesting a link between suicide and SSRIs. After listening to the speakers and hearing contributions from the floor, a majority of psychiatrists supported a "don't know" option when they were re-polled.
The debate took place following recent media coverage in Britain and the Republic suggesting that SSRIs were a direct cause of suicide. SSRIs are a group of anti-depressants that have been widely prescribed in the last decade. They include drugs such as fluoxetine, paroxetine and sertraline.
Congratulating the Irish College of Psychiatrists for looking at the issue, Dr Healy said : "This is not about anti-depressants being the wrong thing. They are the right treatment for many people. However, they must have appropriate warnings".
He said his primary concern was that drug companies have kept psychiatrists in the dark regarding the issue.
Dr Healy presented research evidence which he maintained showed a link between suicide and patients taking a range of SSRI anti-depressants. He referred to figures alleging a suicide rate of 168 per 100,000 patient years in patients prescribed modern anti-depressants, compared to a rate of 64 per 100,000 patient years in those taking a dummy pill.
Prof Casey analysed a review article by Dr Healy published this month in the Journal of Psychotherapy and Psychosomatics. She questioned his conclusions and the quality of the research he had referred to in completing the review.
"There is no scientific evidence to back up Dr Healy's claims that anti-depressants cause suicidal behaviour. He relied excessively on anecdotal reports.
"His meta-analysis [combined assessment of evidence] failed to find any causative link between modern anti-depressants and suicide," she said.
Prof Malone told the meeting that the principal chemical factor associated with suicide was not Prozac, "rather it is alcohol".
He criticised the Royal College of Psychiatrists for not referring to suicide on its website.
"Speaking purely as a scientist, when it comes to something as serious as suicide, you cannot say A causes B. Nothing that Dr Healy has said confirms that taking SSRIs causes suicide," Prof Malone said.
Speaking from the floor, Dr Eleanor Corcoran, a consultant psychiatrist, said, "drug companies are a powerful machine, especially in controlling the media. We must value our independence and keep an open mind on this issue".