Antidepressant-induced suicidality: implications for clinical practice

Abstract

The risk of suicidal behavior associated with antidepressant treatment is an issue of debate and concern. The US FDA has required that antidepressants carry a black box warning that there may be a risk of suicidal ideations in depressed pediatric patients treated with these medications, and recently extended the warning to include individuals up age 24. However studies of antidepressant-induced suicidality in adults have yielded contradictory findings and conclusions. This article discusses investigations of this poorly understood phenomenon and the clinical implications of research findings and FDA warnings for clinicians treating adults with depression. Although antidepressant-induced suicidality apparently occurs only rarely, close monitoring and follow up care after the initiation of a new antidepressant is indicated.