Depression is the real killer, not antidepressants, say commentators

BMJ 2007; 334 doi: (Published 10 May 2007) Cite this as: BMJ 2007;334:974
  1. David Spurgeon
  1. Quebec

    On 2 May the US Food and Drug Administration ordered that all antidepressants must carry an expanded black box warning about an increased risk of suicidal symptoms in young adults aged between 18 and 24 years. But the requirement poses a problem for doctors, says an article published online in the New England Journal of Medicine on 7 May.

    “Whether the new warning will do more good than harm is not clear,” write Richard Friedman and Andrew Leon, both of Weill Cornell Medical College, New York (, doi: 10.1056/NEJMp078015). “The real killer in this story is untreated depression, and the possible risk from antidepressant treatment is dwarfed by that from the disease. But clinicians still need to tell their depressed patients that some people who take antidepressants have an increase in suicidal symptoms, especially early in treatment, and …

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