Beyond Blue

In a recent Johns Hopkins Health Alert, I read this:

Suicide attempts or suicidal thoughts are common symptoms of depression, and the risk of suicide may increase as depression begins to respond to treatment because the person might regain just enough energy and motivation to follow through on a suicidal urge. This discussion addresses the question: Can Taking an Antidepressant Make Me Suicidal?

Here’s how the Johns Hopkins team of psychiatrists answered it:

Whether antidepressants raise suicide risk has been a hotly contested issue since the U.S. Food and Drug Administration (FDA) issued black-box warnings that they could increase suicide risk in children and teenagers, then extended the risk to adults. On the other hand, suicide remains a risk of untreated depression, and research suggests that SSRIs decrease suicide risk by improving symptoms, while the increased use of fluoxetine (Prozac) in the United States has been linked with a lower suicide rate.

The risk of antidepressants increasing suicidal thoughts in those with severe depression appears to occur during the first few treatment weeks or when changing the dose. At this time, when the medications might not yet be having an effect, depression and suicidal thoughts may worsen. Also, when some individuals begin to respond to the medication, they may have just enough energy and motivation to commit suicide. In addition, people with bipolar disorder who have been misdiagnosed with depression and given antidepressants may be at greater risk for suicide.

A good strategy is to stay in close contact with your healthcare provider, family, and friends when you start on an antidepressant or if your dose is adjusted so that they will notice any warning signs if your symptoms worsen. It’s always a good idea, too, to engage in some form of talk therapy, which has been shown to enhance the effectiveness of antidepressants.

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