" The century-old belief that patients with depression are at heightened risk of suicide as they begin to recover and their energy and motivation return21 is being propagated everywhere, e.g. in the 2003 practice guideline from the American Psychiatric Association, which states that ‘clinical observations suggest that there may be an early increase in suicide risk as depressive symptoms begin to lift but before they are fully resolved’.22

Because of this deeply ingrained idea, many psychiatrists believe that when patients become suicidal on an antidepressant drug, it is not an adverse effect of the drug but a positive sign that the drug starts working.7,10 However, a systematic review from 2009 showed that the research that has been carried out contradicts this belief,21 and our review also suggests that it is wrong. We found that antidepressants double the risk of suicidality and violence, and it is particularly interesting that the volunteers in the studies we reviewed were healthy adults with no signs of a mental disorder. Our results agree closely with a review of paroxetine trials in both adults and children with mental disorders using regulatory data released after a court case. It included events both during treatment and in the subsequent withdrawal phase and found a doubling in hostility events (odds ratio 2.10, 95% confidence interval 1.27 to 3.48).23"