Suicide Risks and SSRIs

Since 2005, the FDA has required all antidepressants to carry “black box” warnings clearly delineating an increased risk of suicide in children. The warning was expanded in 2007 to include young adults under the age of 25. Some experts now feel that the warning should be expanded to include people of all ages, although this topic remains controversial.

A black box warning is the strongest warning that a medication can carry. It indicates a strong link between the medication and the listed effect. The decision to enforce a black box warning about an increased risk of suicide is based on repeated scientific evidence that such a link exists.

SSRI Patient Management

SSRIs play an important role in the treatment of social phobia, and can be a helpful adjunct to therapy in treating other types of phobias. While the increased risk of suicide can be a concern, the risk must be weighed against the benefit of the medication. Many physicians choose to manage the risk through close observation of patients that are taking antidepressants. You may be scheduled for frequent appointments, particularly during your first several weeks on a new medication.

Monitoring Your Behavior

It is also important to monitor your own behavior or that of a loved one who is taking an SSRI. Behavioral changes to look for include, but are not limited to, the following:

• Loss of interest in friends, family or activities
• Increased time spent alone
• Anger or hostility
• Restlessness or agitation
• Unusual or prolonged sadness
• Increased anxiety or panic attacks
• Suicidal thoughts or talk of suicide
• Self-injurious behavior

If you notice these or other unusual behaviors, speak with your doctor right away. Do not discontinue your medication without professional guidance, however, as this can lead to a serious physical reaction. The risk of suicide must always be considered, but is not necessarily a reason to discontinue use. Only you and your doctor can decide together what is best for you.