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Check suicide risks with SSRIs, GPs told

GPs must be vigilant in monitoring patients taking SSRIs and tricyclic antidepressants concurrently, researchers warn after finding the vast majority of deaths from SSRIs occurred when patients were taking other drugs as well.

The study, published in this month's British Journal of Psychiatry, found although SSRIs were significantly less toxic than tricyclics, 93 per cent of deaths from the drugs took place in multiple drug overdoses.

The combination of SSRIs and tricyclics was particularly prevalent, accounting for 24.5 per cent of SSRI-related deaths, according to the study by the department of addictive behaviour and psychological medicine at St George's Hospital, London. Alcohol and

opiate-based drugs were also implicated in combination deaths.

Researchers said the increased number of combination deaths with SSRIs could result from the concurrent prescribing of tricyclics for

SSRI-resistant depression.

Study co-author Dr Survjit Cheeta said: 'The present findings do suggest the clinical efficacy of augmentation therapy in SSRI-resistant patients should be monitored carefully because of the risk of suicide.'

The study, which used mortality data from the National Programme of Substance Abuse Deaths between 1998/ 2000 and antidepressant prescription data, also found multiple drug overdoses involving antidepressants were more likely to happen in drug misusers.

GlaxoSmithKline, manufac- turer of paroxetine (Seroxat), said paroxetine is one of the most studied drugs with 'a large amount of safety and effectiveness data from over 10 years of use' and 'benefiting tens of millions of people around the world'.

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