Dr. Juurlink Replies

To the Editor: Dr. Benazzi suggests presenting the absolute risks of suicide during the first month of treatment with SSRI and non-SSRI antidepressants in the abstract of our manuscript. These numbers, however, are only estimates, and their proper interpretation requires the context we provide in the accompanying discussion. This is beyond the scope of an abstract.

Dr. Benazzi offers his speculation about a variety of causal pathways linking SSRIs and suicide. We agree that SSRIs are often used inappropriately, but his hypothesis that prescribing practices are the sole explanation for SSRI-related suicidality defies existing literature as well as basic principles of drug safety. Our findings are consistent with the hypothesis that SSRIs can induce suicidality in a small minority of patients during the initial weeks of therapy.