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Risk of suicidal behaviour in adults taking antidepressants

BMJ 2009; 339 doi: (Published 11 August 2009) Cite this as: BMJ 2009;339:b3066
  1. John Richard Geddes, professor of epidemiological psychiatry1,
  2. Corrado Barbui, lecturer in psychiatry2,
  3. Andrea Cipriani, lecturer in psychiatry2
  1. 1University of Oxford, Warneford Hospital, Oxford OX3 7JX
  2. 2Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Policlinico GB Rossi, 37134 Verona, Italy
  1. john.geddes{at}

    Increased risk is probably restricted to younger people and varies greatly between individual medicines

    Antidepressant drugs currently carry warnings of the possibility of increased suicidal ideation and behaviour during treatment, especially in younger patients. In the linked meta-analysis (doi:10.1136/bmj.b2880), Stone and colleagues report on the possible link between the risk of suicide and antidepressants using data on individual patients from placebo controlled trials.1 This analysis of 372 placebo controlled antidepressant trials and nearly 100 000 patients found that the association between antidepressant drugs and the incidence of reported suicidal behaviour is strongly related to age. The risk was raised in people under 25, not affected in those aged 25-64, and reduced in those aged 65 and older. The analysis also found differences in risk between drugs.

    This analysis is not new—it was published fully on the Food and Drug Administration (FDA) website more than two years ago.2 It was widely covered at the time in the international medical press and led to warnings being included on datasheets.3 4 5 6 Because the …

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