It’s challenging to believe that antidepressants, the drugs which are designed to assist people with depression, might really play a role in increasing suicide risk. And while experts state the jury is still out on whether antidepressants are indeed linked to suicide, one thing is certain: People who are just starting to find an improvement in their depression symptoms might be at the maximum risk of suicide, and this might be why antidepressants have now been perceived as a possible culprit.
“The FDA has warned that kids and adults may show suicidal behavior in the initial weeks of treatment with these drugs, but the actual role is not clear,” says Penny B. Donnenfeld, PhD, a psychologist in private practice in New York City. “There have already been instances where suicide was linked to antidepressants, but whether that was the nature of the depression, a small relief from depressive symptoms, or an actual effect of a drug side effect causing increased agitation and stress is not clear.”
David Sack, MD, CEO of Assurances Treatment Centers in California and also the author of dozens of journal articles on depression, seconds the notion that there might be more factors at work here than merely the antidepressants. “Individuals who are just beginning to improve are at the maximum risk of suicide,” Dr. Sack says. “Energy and concentration improve before someone’s subjective sense of well being. The man still feels awful, just now they have the ability to take a suicidal plan to finish.”
Erroneously Prescribed Antidepressants and Suicide
Donnenfeld says another time when antidepressants might increase bipolar disorder and is first evaluated as having a unipolar depression, antidepressants can add to the individual going into a manic state that may involve risky behaviors,” clarifies Donnenfeld.
Another risk is changing medicines, which also has the potential to create a symptom relapse. “One significant issue that is rarely talked about is when individuals are switched from name brand drugs to generics,” says Donnenfeld. “Often, the generics don’t possess the same therapeutic effect, and patients relapse. Doctors and pharmacists frequently doubt this, but I’ve seen it occur and believe it is a potential issue that needs considerably greater exposure.”
Finding Balance Between Treatment and Dangers
Mental health professionals state that antidepressants help much more than they hurt. “For the most part, they lower the risk because there exists empirical evidence that they fall depression,” says Dena Cabrera, PsyD, a psychologist at Remuda Ranch Programs for Eating and Anxiety Disorders in Wickenburg, Ariz. “There are some cautions for increased danger of suicide with antidepressants, especially with patients under 18. This has to be heeded, but many professionals believe that the dangers of not treating an adolescent with acute depression with the antidepressant are far worse than any threats in the antidepressant.”
Antidepressants and Suicide Risk: Strategies for Success
The key to success, then, will be to carefully track each patient on antidepressants. “Antidepressant drugs are dependable tools for conquering depression,” says Donald P. Hall, MD, the writer of Breaking Through Depression and the manager of Riverside Counseling Center in Leesburg, Va. “Even so, antidepressant medications occasionally increase agitation and impulsivity before their mood-elevating effects seem. Family members and professional caregivers should monitor mood and thoughts about suicide, especially during the initial weeks of antidepressant treatment.”
If you’re on antidepressants and notice something out of the ordinary, Dr. Hall advises acting promptly. It could save your lifetime. “If you develop agitation, insomnia, or impulse-control issues while taking antidepressants, you need to alert your physician as soon as you possibly can,” Hall says. “If you never thought of suicide before but start thinking these thoughts, call for immediate attention. If you thought about suicide but are thinking more intently, call for prompt attention. Tell a friend or loved one what’s going on in your brain. Depression is a serious medical problem, and thoughts about suicide aren’t uncommon in this state of mind.”