Suicide and Antidepressants: Black Box Warning
The FDA adopted a "black box" warning that antidepressants
were found to increase the risk of suicidal thinking and behavior in children, adolescents, and young adults up to the age of 25 in short-term studies of major depressive disorder and other psychiatric illnesses. A black-box warning is the most serious type of warning found on a prescription drug's labeling.
The warning also emphasizes that depression
and certain other psychiatric illnesses may increase the risk of suicide.
Anyone who begins treatment with antidepressant medications should be closely monitored for:
- Worsening depression
- Emergence of suicidal thinking, feelings, or behavior
- Unusual changes in behavior (such as sleeplessness, agitation, or withdrawal from normal social situations).
This monitoring is especially important during the first four weeks of treatment or when a dose is changed. If you or someone you know is taking an antidepressant and develops any of the warning signs listed above, call a healthcare provider immediately.
Never stop taking an antidepressant medication without first talking to your healthcare provider.
Weighing the Risks
Depression is a serious and real medical condition. If left untreated, it can cause a great deal of suffering. In fact, depression itself is an important cause of suicidal thoughts and actions, including completed suicides. However, depression is a treatable illness.
Studies show that there are substantial benefits from medications used to treat moderate and severe depression, even in those with suicidal thoughts. However, all treatments have side effects. Some people may experience an increase in suicidal thoughts and behavior after starting an antidepressant, especially early in treatment.
Currently, the best recommendation is to carefully consider the risks and benefits of antidepressant treatment with your healthcare provider. These risks and benefits may vary depending on your particular situation. Together, you and your (or your loved one's) healthcare provider can choose the most appropriate treatment for your situation. Everyone who begins antidepressant treatment should be closely monitored to help reduce the risk of suicidality.