In 226,866 depressed veterans, suicide attempts were lower in those treated with antidepressants
"Suicide attempt rates were lower among patients who were treated with antidepressants than among those who were not", and lower after starting treatment than before.
Well-supported by good-quality research. how we score evidence
Caveat on this rating: Observational cohort: confounding by indication and by who stays in care. Pre-treatment attempts partly cause the diagnosis and prescription, which inflates the before-treatment rate. Attempts, not deaths. The 18 to 25 group, where the effect was not significant, is the group covered by the FDA boxed warning.
National charts cannot say what happens to the person who takes the drug. Studies of individuals can, within limits. This is the largest one from the years the FDA was deciding whether to widen its suicide warning.
Significant findings
Gibbons and colleagues (American Journal of Psychiatry, 2007) "analyzed data on 226,866 veterans who received a diagnosis of depression in 2003 or 2004, had at least 6 months of follow-up, and had no history of depression from 2000 to 2002."
"Suicide attempt rates were lower among patients who were treated with antidepressants than among those who were not, with a statistically significant odds ratio for SSRIs and tricyclics. For SSRIs versus no antidepressant, this effect was significant in all adult age groups. Suicide attempt rates were also higher prior to treatment than after the start of treatment". For SSRIs the before-and-after effect "was seen in all adult age groups and was significant in all but the 18-25 group."
The authors' conclusion: "These findings suggest that SSRI treatment has a protective effect in all adult age groups. They do not support the hypothesis that SSRI treatment places patients at greater risk of suicide."
Worth asking
It is observational. Veterans who were prescribed a drug and stayed in follow-up differ from those who were not, and attempts that lead to a diagnosis also lead to a prescription, which flatters the after period. The one group where the effect was not significant, ages 18 to 25, is the group the FDA's warning covers. But anyone who reads a flat national suicide rate as proof that antidepressants do nothing has to account for this. If you take one, never stop on your own. If you are in crisis in the US, call or text 988.
Source
Relationship between antidepressants and suicide attempts: an analysis of the Veterans Health Administration data sets — Gibbons RD, Brown CH, Hur K, Marcus SM, Bhaumik DK, Mann JJ (2007)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1176/ajp.2007.164.7.1044
DOI: 10.1176/ajp.2007.164.7.1044
How this was scored
- Study design
- Cohort study
- Funding
- Independently funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 226,866
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 21, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "strong evidence". Well-supported by good-quality research. It scores 70 out of 100 on our published rubric. One caveat travels with that badge: Observational cohort: confounding by indication and by who stays in care. Pre-treatment attempts partly cause the diagnosis and prescription, which inflates the before-treatment rate. Attempts, not deaths. The 18 to 25 group, where the effect was not significant, is the group covered by the FDA boxed warning. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Relationship between antidepressants and suicide attempts: an analysis of the Veterans Health Administration data sets — Gibbons RD, Brown CH, Hur K, Marcus SM, Bhaumik DK, Mann JJ (2007). Published in: Top-tier peer-reviewed journal. DOI: 10.1176/ajp.2007.164.7.1044. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Cohort study. Funding: Independently funded. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.