You take antidepressants to stop depression, right? A lot of people started worrying in the '90s that certain antidepressants might cause suicidal behavior in patients. A recent study in the Journal of the American Medical Association considers a possible connection between antidepressants and suicidal behavior.

What the researchers wanted to know: Are certain antidepressants more likely to cause suicidal behavior in patients? Are teenagers different from adults?

What they did: Using the UK General Practice Research Database (a database where general practitioners keep comprehensive, anonymous data on over 3 million patients), researchers at Boston University looked at 2,617 users of one of four popular antidepressants: fluoxetine, paroxetine, amitriptyline, and dothiepin. The researchers matched patients who became suicidal after starting the drugs to patients who didn't. To be counted as suicidal, a patient had to have received at least one prescription for only one of the study drugs within 90 days before he or she began contemplating suicide. The control and suicidal patients were matched by age, sex, and duration of partipation in the GPRD.

What they found: The researchers found no notable differences between the four study drugs, although one of the drugs, paroxetine, seemed a little worse—but the results are not statistically significant. Patients were four times more likely to think about suicide in the first nine days after beginning antidepression medication than after 90 days. The reseachers suggest three possible reasons why people who just started antidepressants could become suicidal: the treatment might not be immediately effective; second, when patients begin antidepressants, they are usually at their lowest point and are, therefore, more likely to be suicidal; or third (and least likely), antidepressants might actually cause depression to worsen to suicidal levels. The researchers didn't find any difference in results for teenagers.

What this means to you: Over 31,000 Americans commit suicide annually. The more we can learn about antidepressants, the better. Also, at the moment, it doesn't seem that some antidepressants are more likely than others to cause suicide.

Caveats: Since the study looked at first-time prescriptions, the results cannot necessarily be applied to patients who have changed antidepressants or to patients who have any of the psychiatric or medical conditions (including drug abuse and eating disorders) blocked in the study. The researchers say they didn't have enough information about teenagers to say definitely that teenagers on antidepressants aren't killing themselves more often than adults.

Find out more: Depression resource center: http://my.webmd.com/medical_information

Read the article: Jick, Hershel, M.D. et al. "Antidepressants and the Risk of Suicidal Behaviors." Journal of the American Medical Association. July 21, 2004, Vol. 292, No. 3, pp. 338–343.