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Antidepressants and suicide symptoms: compelling new insights from the FDA’s analysis of individual patient level data

¹ Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
² Department of Psychiatry, Warneford Hospital, University of Oxford, UK

Correspondence to:
Dr M Henderson, Division of Psychological Medicine, Institute of Psychiatry, King’s College London, 3rd Floor, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK; m.henderson@iop.kcl.ac.uk

The first 150 words of the full text of this article appear below.

In May 2007 the Food and Drug Administration (FDA) ordered that all antidepressant drugs carry an expanded black-box warning incorporating information about an increased risk of suicidal symptoms in young adults aged 18–24 years. The new warning was based on the results of a FDA meta-analysis that included 372 placebo-controlled antidepressant trials and nearly 100 000 patients.¹ On the basis of this analysis the relationship between antidepressant drug treatment and the incidence of reported suicidal behaviour in clinical trials was strongly related to age: the risk associated with drug treatment relative to placebo was found to be elevated in subjects under age 25, neutral in subjects aged 25–64 (reduced if suicidal behaviour and ideation are considered together), and reduced in subjects aged 65 and older.

Paradoxically, these data have been interpreted as reinforcing and consolidating two opposing positions. On one side, it has been argued that antidepressant drugs do not . . . [Full text of this article]