In the last few years the FDA has issued advisories that antidepressants may increase suicidality. This has caused much concern for psychiatrists and for their patients who are on antidepressants. But there are some problems with the studies that raised the possibility that suicidality may be increased in people who are on antidepressants.
One is that the studies were very short term (less than 2 months long). Another is that the studies defined "suicidality" in terms of suicidal thoughts, rather than suicide attempts. Finally, the studies excluded people who had complex medical issues, other psychiatric problems besides depression, or who had had suicidal thoughts in the weeks prior to the start of the study. All of these issues decrease the ability to confidently generalize from the study to all people who struggle with depression.
Even more important, studies are now emerging that show a reduced rate of suicidality in people who are treated with antidepressants (One example is A.C. Leon's May 2011 study published Journal of Clinical Psychiatry; read the article).
My conclusion is that whenever someone starts a medication, they should talk with their doctor about the potential risks versus benefits. But I think it's premature to get rid of the option of antidepressant treatment, since they do alleviate a significant amount of suffering.
Joseph M. Jeral, M.D.
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