5-HT reuptake inhibitors, tricyclic antidepressants and suicidal behaviour

Antidepressant drugs undoubtedly reduce much of the morbidity and mortality associated with a variety of depressive disorders. Certain types of antidepressant drugs have been shown to exert a relative advantage in the reduction of suicidal thoughts, and it is interesting that recent reports have noted an association between the prescription of some antidepressants and the development of suicidal and aggressive thoughts and behaviour. An analysis of the data from double-blind controlled trials of fluvoxamine, fluoxetine and paroxetine indicates that 5-HT uptake inhibitors exercise some protective effects on the emergence of suicidal thoughts, whereas the data from the studies with maprotiline show an increase in suicidal thoughts compared with placebo.