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A small proportion of individuals under age 24 beginning antidepressant treatment are at risk for increases in suicidal ideation or behavior. Researchers analyzed data from the Sequenced Treatment Alternatives to Relieve Depression study (STAR*D) to see whether this phenomenon recurs during second-stage treatment.
After insufficient response in stage 1 to open-label citalopram, 1240 patients entered second-stage treatment (treatment switches or augmentation), in which 102 (8.2%) experienced emergence or worsening of suicidal thoughts or behavior. The percentage of stage-2 suicidal patients with stage-1 suicidality emergence or worsening (27 of 121 patients; 22.3%) was almost four times higher than the percentage of those without stage-1 suic…