DEPRESSED PATIENTS IN PAROXETINE/PLACEBO TRIALS WITH DEFINITIVE SUICIDAL BEHAVIOUR AND IDEATION - RANKED BY AGE GROUP [ex Table 2.10]
The point of this compilation, based on company data, is to question GSK's assertion that the increased risk of adult suicidal behavior on paroxetine "was driven primarily by events occurring in the younger adult" - i.e. that the results for adults of all ages may be best explained by the excess numbers of younger people with ill-effects. The Table below reveals a scatter that offers little support for GSK's view - notwithstanding the generally higher concentration of adverse effects in younger age groups.
In any case, it seems worth making a distinction between susceptibility to drug-induced suicidal impulses; and the influence of age on containing suicidal behaviour. Hypothesis: the incidence of drug-induced suicidal behaviour may not be age-related to the extent supposed; the observed differences between different age groups may also, perhaps primarily, be due to the resources older or younger people have for coping with suicidal impulses.
In short: a similar proportion (and a small minority) of people in all age groups may experience the toxic effects of the drug, but older people (more stable, resourceful, experienced, resilient etc?) may be better able to cope with them than younger ones.
GlaxoSmithKline's presentation and analysis of the same data emphasises the differences between people aged above and below 25 (and 29). The age-bands in this table represent broadly similar sized cohorts, with all but the last ranged in five-year intervals. This underlines the elements of trend and continuum, and challenges the notion of any specific age as a cut-off point.:
| Age range (years) | Suicidal behaviour on paroxetine [numbers (%)] | Suicidal behaviour on placebo [numbers and %] |
| 18-22 | 5/147 (3.4%) | 0/104 (0.0%) |
| 23-27 | 2/250 (0.8%) | 2/154 (1.3%) |
| 28-32 | 6/386 (1.5%) | 2/215 (0.9) |
| 33-37 | 4/415 (1.0%) | 1/215 (0.5%) |
| 38-42 | 4/406 (1.0%) | 3/258 (1.2%) |
| 43-47 | 2/394 (0.5%) | 0/202 (0.0%) |
| 48-52 | 4/296 (1.4%) | 1/184 (0.5%) |
| 53-57 | 0/246 (0.0%) | 0/138 (0.0%) |
| 58-62 | 1/293 (0.3%) | 0/174 (0.0%) |
| 63-67 | 0/251 (0.0%) | 1/139 (0.7%) |
| 68+ | 3/371 (0.8%) | 0/229 (0%) |