Antidepressant treatment trugs include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). The incidences of SSRI-induced suicides date back to the 1990s, but the exact association between antidepressant drugs and suicidality and aggression is not clear. This study aims to evaluate the incidence of suicidality and aggressive behavior associated with the intake of SSRIs and SNRIs.

This systematic review and meta-analysis included 70 double-blind placebo-controlled trials that contained data about 18,526 patients who underwent antidepressant treatment and reported aggressive and suicidal behavior. The primary outcome of eth study was the incidence of mortality and suicidality.

The quality of evidence obtained from the included studies was of low quality and had several discrepancies. For these reasons, deducing a concrete association between antidepressant treatment and aggressive behavior was not possible. However, some studies showed that patients taking antidepressants displayed more aggressive behavior (odds ratio 1.93). However, differences in mortality (1.21), suicidality (1.21), and akathisia (2.04) were not different. The odds for suicidality and aggression were lower for adults and higher for children.

The research concluded that antidepressant treatment using SSRIs and SNRIs was associated with a higher risk of aggressive behavior and suicidality. But the quality of evidence was low, and more in-depth research on the topic is required.