More Contact Needed

There is a physiological answer to the question of whether antidepressants are linked to suicide, described so well in the April 1 article “SSRI Data Continue to Confound Researchers.” The reason some persons act out their suicidal ideas soon after starting an antidepressant is that the drug stimulates physical action before it eliminates ideas and moods, so a person with suicidal ideas and feelings is more likely to act them out in the first few weeks after starting the new drug.

I have learned to increase the contact with the suicidal patient and his or her family after starting a new medication so that I am in constant control of the situation and can prevent any acting out of the suicidal ideas and wishes. I describe this method in the new, upcoming edition of my book Treatment of Depression and Related Moods—A Manual for Psychotherapists.

I hope this message helps prevent loss of life. Unfortunately, nowadays many depressed persons are given antidepressants by people who do not specialize in psychiatric illness, such as family physicians, or psychiatrists who prescribe medication and neglect psychotherapy.