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Depending on where the demographics you would expect as high as 1 successful suicide per 5,000 men per year. So, randomly having a successful subside in a 320 person study is not that unlikely. Unsuccessful suicides are more common. So, there is not really enough data to suggest a strong link.

Most likely the other side effects where the issue.



But if the treatment appears to cause severe mood swings in some cases, would that not suggest there's a good chance that it was a factor in the two suicide attempts (one successful)? Or is it counterintuitive?


There is a good chance, yes. And it's probably a good reason to stop this trial if that was completely unexpected. But I don't think that that's the last we will hear of this treatment if there is a market for it, which there seems to be.

For example, Isotretinoin https://en.wikipedia.org/wiki/Isotretinoin (known as Accutane/Roaccutane and by other names) is also associated with depression and suicidal behavior. It's still a popular drug used to treat acne, even though that is not a particulary dangerous disease.

I don't know anything about how the pharma industry works, but I'd guess they'll restart the trial, taking depression into account and watching for signs among the participants. And maybe with a lower dosage?


Yes, I strongly suspect that isotretinoin is responsible for my very soon after developing a chronic pain disorder and mood swings. After talking to others afflicted by chronic pain it turns out to be a rather common factor :( there's even a pretty plausible mechanism of action (to do with inflammation, which if you've ever been subject to the stuff, I suspect won't surprise you in the least...) Had I known about any of this (to be clear, I just mean the risk - not my actual outcomes. No predictions of the future necessary) prior to taking it, I'd never have considered it.


It's too small to have statistical confidence, and we shy away from experimenting directly on the suicide rate.




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