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SSRI antidepressants cause aggression

Treatment of depressive patients should start with non-drug measures. Antidepressants should be reserved for incapacitating disorders that are resistant to these measures, and patients should be closely monitored.

It has been recognised since 2000 that selective serotonin reuptake inhibitors (SSRI), particularly paroxetine, can lead to suicidal behaviour in children and young adults.

Pharmacovigilance reports mention symptoms of aggression associated with these antidepressants in patients of all ages: agitation, irritability, hostility, aggression, impulsiveness, violence, even homicide.

In numerous clinical trials, this behaviour went unnoticed as it was classed under the general term “hostility”, thus trivialising violent and aggressive behaviour which was much more frequent in patients taking SSRI antidepressants than in those given a placebo. Many reports from patients or their families confirm numerous cases of aggression.

Antidepressants should be reserved for patients whose disorder is incapacitating and resistant to non-drug treatment. Patients should be closely monitored, especially children and adolescents, at the beginning of treatment when the dose is adjusted, and when treatment is halted.

©Prescrire June 2008

Reference: "Antidépresseurs IRS et violence" Rev Prescrire 2008 ; 28 (296): 431-432.

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