BMJ  2005;330:373-374 (19 February), doi:10.1136/bmj.330.7488.373

Editorial

Suicide, depression, and antidepressants

Patients and clinicians need to balance benefits and harms

The first 150 words of the full text of this article appear below.

Unipolar depression, one of the most important causes of disability worldwide,¹ is characterised by depressed mood, hopelessness, helplessness, intense feelings of guilt, sadness, low self esteem, thoughts of self harm, and suicide. Up to 15% of patients with unipolar depression eventually commit suicide.² Although clinical guidelines recommend treating moderate to severe depression with antidepressant drugs,³ debate persists on whether some antidepressant drugs, in particular the selective serotonin reuptake inhibitors (SSRIs), cause the emergence or worsening of suicidal ideas in vulnerable patients. New insights on this key issue have been provided by three articles published in this issue.

Fergusson et al conducted a systematic review of published randomised controlled trials comparing SSRIs with either placebo or other active treatments in patients with depression and other clinical conditions.⁴ They found an almost twofold increase in the odds of fatal and non-fatal suicidal attempts in users of SSRIs compared with users of . . . [Full text of this article]

Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, 37134 Verona, Italy (andrea.cipriani@medicina.univr.it)

Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, 37134 Verona, Italy

Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX

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• Cipriani, A. (2005). Forensic database study suggests selective serotonin reuptake inhibitors do not increase the risk of suicide in people taking antidepressants. Evid. Based Ment. Health 8: 113-113 [Full text]  
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