Fluoxetine and suicidal ideation--a review of the literature.

The emergence of suicidal ideation has been noted in some case studies, where fluoxetine administration appears to be the precipitating agent. However, these observational claims are not supported by the clinical trial literature. A review of some of the trials and the case histories is followed by an assessment of the evidence, and possible explanations for the discrepancy. It is concluded that a definite link between fluoxetine and emerging suicidal ideation cannot be ascertained, but that further research is indicated. Vigilance in prescribing any antidepressant medication, including fluoxetine, is recommended.