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I have been puzzled at the consternation over the findings in this article. It’s common knowledge among people who treat patients with major depression that the time of greatest risk for suicide is when depression begins to lift. The person finally has more energy and mental focus but may still feel awful. Resolved never to feel so bad again, they use their increasing energy to plan and carry out suicides. Hence, one would predict that an effective antidepressant might well lead to increased suicide attempts early in treatment.

Joel Denney
Oakland, Calif.