Question: In adults with depression, what is the association between antidepressant use and suicidal behaviours?

Answer:

Evidence from one good quality systematic review and one large, well conducted, nested casecontrol study suggests that, whilst selective serotonin re-uptake inhibitor (SSRI)/antidepressant use was associated with reduced suicide risk in adults and older adults, it may be associated with increased risk in children and young adults. Data from the case-control analysis also indicated that, in people treated with antidepressants, periods of treatment initiation, discontinuation and dose change were all associated with increased suicide risk. Given the complexity of the issue of confounding when exploring the relationship between antidepressant use and suicide risk, further large scale studies, particularly looking at antidepressant groups other than SSRIs, may be useful to confirm and expand upon these findings.

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