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Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i65 (Published 27 January 2016) Cite this as: BMJ 2016;352:i65

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Re: Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports

In regard to aggressive behaviors in youth while taking antidepressant medications, earlier research has demonstrated the high prevalence of excessive anger and violent behaviors in psychiatric outpatients prior to the initiation of treatment.

In a study of 1,300 people presenting to a psychiatric outpatient practice, one half of the people had moderate to severe anger before beginning therapy with the level of anger being comparable to the levels of depression and anxiety. Also, one quarter of those in the study had demonstrated aggressive behavior in the preceding week. (Posternak, MA: Anger and Aggression in Psychiatric Outpatients.” J. Clin Psychiatry. 2002, 65: 442-443).

Excessive anger and violent behaviors in youth and in adults are a direct result of depressive illness and emerge regularly during the course of treatment.

The evaluation and the treatment of the excessive anger in adults and in youth with depressive illness should be part of the treatment protocol.

Competing interests: No competing interests

07 February 2016
Richard P. Fitzgibbons
Psychiatrist
Private practice, co-author Forgiveness Therapy: An Empirical Guide for Resolving Anger and Restoring Hope. APA Books, 2014.
101 W. Elm St., Conshohocken, PA 19428