Two large-scale studies add to the evidence that antidepressant drugs decrease, rather than increase, the risk of suicidal behavior. Simon et al. (CME, p. 1029) report patterns of suicide attempts among 109,256 individuals in a prepaid health plan who were treated for depression. Suicide attempts were most common in the month before treatment began, next highest in the first month of treatment, and still lower as treatment continued. This progression occurred for both medication and psychotherapy and also was seen in adolescents and young adults specifically. A decline in suicide attempts after the start of antidepressant treatment was also demonstrated by Gibbons et al. (p. 1044). Data on 226,866 depressed veterans showed both a decrease within the same patients after treatment and a lower rate of suicide attempts in patients taking selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants than in patients who did not receive antidepressants. These differences were seen for all age groups, including 18–25-year-olds. Posner et al. (CME, p. 1035) describe the system used to classify suicidal events in the Food and Drug Administration’s analysis of the suicidality risk for children and adolescents in antidepressant clinical trials, as well as in adult clinical trials of antidepressants and numerous other centrally acting agents, including anticonvulsants and cannabinoid 1 receptor inverse agonists. Compared to the pharmaceutical companies that conducted the pediatric trials, the raters using the Columbia Classification Algorithm for Suicide Assessment identified more adverse events as possibly suicidal, but they classified only half as many as actual suicide attempts. An editorial by Dr. David Brent on p. 989 reviews these findings.