[Antidepressants, depression and suicide].

AIM: The goal of this paper is to analyse the complex relationship between antidepressants, depression and suicide.
METHOD: Review and synthesis of the Hungarian and English language international literature, published on this topic in the last 15 years.
RESULTS: Large-scale, retrospective and prospective, naturalistic ("real life") studies show that compared to patients without treatment antidepressants and mood stabilizers reduce the risk of completed and attempted suicide by about 80%. This anti-suicidal potential is significantly higher than the small increase in suicidality of patients taking antidepressants in placebo controlled randomized Phase II/III trials. New data show that based on clinical data this small subgroup can be identified and successfully treated using specific therapy.
CONCLUSION: Suicidal behaviour in patients taking antidepressants is mostly the consequence of the lack of antidepressant effect and is rarely the result of suicide-inducing potential of antidepressants. This rare latter case is most frequently the consequence of antidepressant monotherapy of bipolar depression. Appropriate use of antidepressants and mood stabilizers plays a key role in suicide prevention of patients with affective disorders.