Suicidality associated with antidepressant use

In a small proportion of patients, antidepressants cause a transient increase in suicidality (occurring within the first 7 to 10 days of treatment); this effect has been most often observed with selective serotonin reuptake inhibitors (SSRIs). Young people (up to the age of 30 years) are most susceptible to this effect. The mechanism is not fully understood but may relate to the induction of agitation or akathisia.

When starting an antidepressant for a patient, discuss the possibility of activation and suicidal thoughts, and develop a plan for responding to these symptoms if they occur. Monitor the patient closely for these effects at the start of treatment. See also Suicide risk.