Suicidality and antidepressants in the elderly

Abstract

Suicidality is a serious clinical concern that influences mental health treatment in the elderly. It manifests across a continuum that spans from suicidal ideation to completed suicide and is an urgent public health problem; both the rate and lethality of suicide attempts in the geriatric age group are increased relative to younger persons. Recent concern about a relationship between antidepressant use and suicidality raises questions about the risks associated with this treatment modality for depression and other mood disorders. This review delineates the known risk correlates of suicidality, summarizes studies on the relationship between antidepressants and suicidal manifestations, and concludes with a practical management strategy given the current evidence base.