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.