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Antidepressants and Suicide Risk

FDA Black Box Warning

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Updated April 22, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Antidepressant medication is commonly prescribed to treat both mood and anxiety disorders. However, over the past several years, a potential link between antidepressant use and increased risk of suicidal thoughts and behaviors has emerged. Despite these concerns, antidepressants remain one of the most common treatment options for panic disorder.

The controversy began in 2007 when research studies determined the possibility of this connection, prompting the U.S. Food and Drug Administration (FDA) to release a warning. The FDA cautioned that the use of antidepressants may potentially lead to increased suicidal thoughts and behaviors. The FDA also warned that this issue is especially problematic for children, adolescents, and young adults under the age of 25 who are taking antidepressants.

Known as a black box warning, the FDA now requires that all antidepressants indicate this risk, along with a list of common symptoms of suicidal thinking, and other warning signs of what to look for to prevent risk of suicide.

What Antidepressants are Prescribed to Treat

First introduced in the 1950s, antidepressants were initially used to treat major depressive disorder. It was later determined that antidepressants can be used to effectively treat a variety of mental health and medical conditions. Antidepressants are currently prescribed for the treatment of certain elements of bipolar disorder, obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), generalized anxiety disorder, eating disorders, irritable bowel syndrome (IBS), social anxiety disorder, panic disorder (with or without agoraphobia), and other conditions.

The Signs of Suicide

It is rare that someone taking antidepressants will experience increased suicidal thoughts or behaviors -- however, there are some people who might. People first starting out on antidepressants, especially young people, should be monitored. When beginning to take an antidepressant, prescribing doctors will look for worsening signs of depression, thoughts of suicide, and unusual behaviors.

Additional warning signs for suicide include:

  • Increased symptoms of depression
  • Feelings of hopelessness and worthlessness
  • Loss of interest in previously enjoyed activities
  • Thoughts and preoccupation with death and suicide
  • Giving away personal items
  • Distancing self from family and friends
  • Abrupt change in mood from extreme sadness to feeling calm or happy
  • Threats of suicide
  • Having or discussing a plan for taking one’s life
  • Increased risk-taking

Getting Help

Seek immediate help if you or someone you know is suicidal. To get help right away, call 911 or a suicide prevention hotline.

The following toll-free hotlines in the U.S. are staffed with professionals who are available 24 hours a day to take your call:

National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

National Suicide Prevention Hotline: 1-800-SUICIDE (1-800-784-2433)

Sources:

American Foundation for Suicide. Warning Signs of Suicide.

Dudley, William. Antidepressants. San Diego, CA: Reference Point Press, 2008.

Food and Drug Administration. New Warnings Proposed for Antidepressants.

Silverman, Harold M. The Pill Book. 14th ed. New York, NY: Bantam Books, 2010.

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