Antidepressant medications can be of great help in treating people who have become suicidal. Whether you are dealing with people who only have suicidal ideation, or with people who have actually attempted to commit suicide, anti-depressants can be of great help.

Suicidal patients need to be evaluated by psychiatrists, before they can be put on anti-depressant medications. It takes a psychiatrist to figure out whether a given patient would be best served by taking anti-depressant medications or not.  There is a certain criterion or rather, a certain checklist, that a psychiatrists goes through mentally, before making a decision on whether or not to put a patient on anti-depressant medications. But generally, if a patient’s depression has gotten to a point where it is causing suicidal ideation, it warrants treatment using anti-depressants. But you could be dealing with a complex situation: like where someone attempted to go through the UPSers sign up process, only to keep on failing. The person in question may turn out to have been one of the former Upsers (that is, people who were working for UPS), trying to get his job back. Upon failing in that endeavor, he develops suicidal ideation. In such cases, it can be very hard for a psychiatrist to make a decision on whether or not to put the patient on anti-depressant medication. For clearly, although the patient has developed suicidal ideation, it is not due to chronic depression — but rather due to life challenges that can possibly be dealt with through counseling and cognitive therapy.

All said and done, there are three challenges that tend to arise (for psychiatrists), while using anti-depressants to treat suicidal patients.

The first challenge is that of identifying the best anti-depressant medications for use in treatment of specific patients. You see, some of these medications have paradoxical effects: where, rather than reducing the suicidal ideation, they enhance it!

The second challenge is that of figuring out the right dosage for use in the treatment of suicidal patients.

The third challenge is that of figuring out when to get the patients off the anti-depressant medications. Here, the problem is in the fact that the patients may relapse into suicidal ideation, if they are taken off the medication. Yet, at the same time, they may be averse to the idea of using the medication for a lifetime — hence presenting a dilemma for the psychiatrist.