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Comment by ekianjo | Hacker News Reader

> Once they go on antidepressants, they go on suicide watch. It's the most dangerous time. Because they'll still be depressed, but they'll finally have the energy to get up. And they just might have the energy to do themselves in.

Not sure if you can really generalize this much. There are several studies studying the effect of antidepressants on suicide rates, and it's true that some of them seem to lead to more suicides but it's far from being something that you can categorize like that.

I'd also wager there are lots of suicides that could be avoided if people got the medical attention they needed on time.

It's not all black and white.

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Warfangle is correct, I was warned specifically about this when I started treatment. When you go on an SSRI, your fatigue lifts before your mood does, which can lead to a few dangerous weeks.

Can confirm, "my" SNRI's package insert (it is about one meter long, in small print) warns that when starting treatment there's an increased risk of suicidal thoughts/suicide, especially in people under 25.

Fun fact: The package insert also states: "It isn't completely clear how antidepressants work, but they can help increase the Serotonin and Noradrenaline levels in the brain." Very confidence-inspiring :-/

> Fun fact: The package insert also states: "It isn't completely clear how antidepressants work, but they can help increase the Serotonin and Noradrenaline levels in the brain." Very confidence-inspiring :-/

Well at least it's fair. The chemistry of the brain is still very poorly understood.

Note that many drugs were discovered to have effects before we knew HOW to explain why they work.

This is admittedly anecdata, but a close member of my family just committed suicide this week, after starting SSRIs a few weeks earlier.

The family saw a therapist for counseling (not the therapist responsible for the SSRIs) yesterday and her opinion was that prescribing an SSRI without an accompanying mood stablizier was extremely risky. There's certainly a contingent of mental health workers who feel this is a real risk.

Simultaneously, a different member of the family has been on SSRIs under her primary care provider's oversight alone - something we finally convinced her was a bad idea. I wonder how common this practice has become, and if it's contributed to the overall increase in U.S. suicide rates.

I'm sorry for your loss.

They often lead to more suicides _at the beginning of treatment_, but less suicides in the long run.

That's why hospitalization is often necessary when beginning treatment for depression when that depression includes suicidal ideation, but is not necessary for the duration of treatment.

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