ABSTRACT
It is generally assumed that antidepressant treatment reduces the suicide risk. However, in spite of some positive epidemiologic findings2,3, the evidence for this is shockingly scarce. This sceptical statement refers particularly to the effect of long-term medication1,4. The assumption might explain the fact that, to date, drug regulatory agencies have not considered changes of the death rate as an essential endpoint criterion for approval of new antidepressants or ‘mood stabilizers’. The present debate on the suicidality-inducing effects of selective serotonin reuptake inhibitors (SSRIs) and other antidepressants adds another question mark as to the net effects of long-term
antidepressive treatment in terms of suicide prevention5. The recent re-analysis of data from the Zurich cohort by Angst et al. is one notable exception, suggesting a mortality-reducing effect of antidepressants, as well as neuroleptics and lithium6,7.
