Selective serotonin reuptake inhibitor associated suicidal ideation: a case report

Shatavisa Mukherjee, Sukanta Sen, Malay Kumar Ghosal, Santanu Kumar Tripathi


This report describes a patient suffering from somatoform disorder that developed suicidal ideation specifically due to the treatment with sertraline. After 6-7 months on the regimen, she presented slight suicidal ideations. However, with gradual progress of time and continuation of the therapy, the ideation became intense. She complained of intense restlessness and anxiety. She presented with fresh cuts and bruises on her left arm and neck. On reporting the problem, the drug was withdrawn. Patient experienced gradual improvement in her state. The case report underlines the importance of onset of suicide risk in panic disorders due to specific antidepressants, selective serotonin reuptake inhibitors (SSRIs). The exact neurobiological basis of depression though being uncertain, the role of serotonin has been mostly implicated. Hypothetically, biological alterations in the serotonergic system might have contributed to the suicidal ideation/attempt in the presence of an SSRI. The present case attempts to highlight an incidence of development of suicidal ideation in a patient who is on chronic SSRI therapy.


Selective serotonin reuptake inhibitors, Sertraline, Suicidal ideation

Full Text:



Breggin PR. Suicidality, violence and mania caused by selective serotonin reuptake inhibitors (SSRIs): a review and analysis. Int J Risk Saf Med 2004;16:31-49.

Information on suicide prevention. Available from: [Last accessed on 2014 Apr 17].

Malkesman O, Pine DS, Tragon T, Austin DR, Henter ID, Chen G, et al. Animal models of suicide-trait-related behaviors. Trends Pharmacol Sci. 2009;30(4):165-73.

Goodwin FK, Jamison KR. Manic-Depressive Illness: bipolar Disorders and recurrent Depression. New York: Oxford University Press; 2007.

Pittenger C, Duman RS. Stress, depression, and neuroplasticity: a convergence of mechanisms. Neuropsychopharmacology. 2008;33(1):88-109.

Dwivedi Y, Rao JS, Rizavi HS, Kotowski J, Conley RR, Roberts RC, et al. Abnormal expression and functional characteristics of cyclic adenosine monophosphate response element binding protein in postmortem brain of suicide subjects. Arch Gen Psychiatry. 2003;60(3):273-82.

Mann JJ. Neurobiology of suicidal behaviour. Nat Rev Neurosci. 2003;4(10):819-28.