The risk of suicidal behavior associated with antidepressant treatment is an 
issue of debate and concern. The US FDA has required that antidepressants carry 
a black box warning that there may be a risk of suicidal ideations in depressed 
pediatric patients treated with these medications, and recently extended the 
warning to include individuals up age 24. However studies of 
antidepressant-induced suicidality in adults have yielded contradictory findings 
and conclusions. This article discusses investigations of this poorly understood 
phenomenon and the clinical implications of research findings and FDA warnings 
for clinicians treating adults with depression. Although antidepressant-induced 
suicidality apparently occurs only rarely, close monitoring and follow up care 
after the initiation of a new antidepressant is indicated.