Antidepressants reduce suicide risk by 20% in patients with affective disorders, according to new cohort study


In November 2007, the US Food and Drug Administration required that black box warnings be placed on all antidepressant medications warning they may result in increased risk of suicidal tendencies in children and adolescents. It is now considered good practice that patients of all ages who initiate antidepressants should be monitored for clinical worsening or suicidality.

However, since the introduction of this black box warning, some epidemiological studies have reported rises in suicide rates in Norway and the USA (Gibbons et al).

This observational study conducted by a research team from Weill Cornell Medical College in New York, examined the association of antidepressants with suicide attempts and with suicide deaths.

The researchers analysed a large prospective cohort of 757 depressed patients who were followed up for up to 27 years.

Here’s what they found:

  • The risk for any suicidal action with antidepressant treatment was 20% lower than without
  • Patients with severe depression were more likely to receive treatment with antidepressants
  • This suggests that antidepressants, overall, may reduce suicidality in a treatment-seeking population and that associated risks can be safely managed

The authors concluded:

This longitudinal study of a broadly generalizable cohort found that, although those with more severe affective syndromes were more likely to initiate treatment, antidepressants were associated with a significant reduction in the risk of suicidal behavior. Nonetheless, we believe that clinicians must closely monitor patients when an antidepressant is initiated.

If you need help

If you need help and support now and you live in the UK or the Republic of Ireland, please call the Samaritans on 116 123.

If you live elsewhere, we recommend finding a local Crisis Centre on the IASP website.

We also highly recommend that you visit the Connecting with People: Staying Safe resource.


Leon AC, Solomon DA, Li C, Fiedorowicz JG, Coryell WH, Endicott J, Keller MB. Antidepressants and risks of suicide and suicide attempts: a 27-year observational study. J Clin Psychiatry. 2011 May;72(5):580-6. [PubMed abstract]

Gibbons RD, Brown CH, Hur K, et al. Early evidence on the effects of regulators’ suicidality warnings on SSRI prescriptions and suicide in children and adolescents. Am J Psychiatry 2007;164:1356–63. [PubMed abstract]

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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