What black box warning are you talking about?

The only one I see for Zurzuvae is: "IMPAIRED ABILITY TO DRIVE OR ENGAGE IN OTHER POTENTIALLY HAZARDOUS ACTIVITIES"[1]

[1]https://documents.sage-biogen.com/us/zurzuvae/pi.pdf

My bad - not a black box in this case. Just a regular box. Sorry for the confusion.

* * *

I haven't yet read the clinical trial results, but suicidal ideation has turned out to be a shockingly common side-effect of many other types of anti-depressants. The comment was unnecessarily inflammatory, but the concern is reasonable.

Hey, you know what causes suicide more than anything else? Depression. Especially untreated depression. And no, cannabis is not a mental health panacea now matter how many times you claim it is. In fact it generally seems to worsen depression. Never have I been more depressed than when smoking daily. It's nothing but a crutch.

Charles Whitman received Valium, and he loved his Dexedrine. He brought along a goodly supply of Dexedrine when he climbed the clock tower at the University of Texas.

The Columbine kids were well-medicated. Remarkably, despite their prescriptions, they were yet to be diagnosed with any mental illness.

When you read about someone who committed crimes, or merely caused a police-involved disturbance, the media will often say that "they had a history of mental/behavioral issues", which means that they were likely taking psychotropic drugs at the time of the incident. Many people choose "suicide by cop" which has been notoriously easy to do.

The FDA still grudgingly labels a few drugs with the "homicidal ideations" spiel, but not as many as they used to.

The sample size is small enough that the correlation vs causation question still goes strong. You're arguing causation, the FDA argues correlation. Is it because they're taking the drugs, or because they're the type of person who would be taking those drugs and therefore have some kind of issue that needed help? It can be hard to know. Did they have these ideas or desires before taking the medication, or only after? If they are young, is it because of the meds, or because they're an angsty and hormonal teenager who has mental issues, or did the drugs exacerbate that?

It's easy to say "look at all these very public cases where this bad thing happened, and they all have this in common!", but that doesn't tip the needle for correlation vs causation at all imo.