Comments on the article by Teicher et al (PA Vol 77:18011) in which the reaction of 6 depressed patients briefly exposed to fluoxetine was described as intense violent suicidal preoccupation. The specific pharamacologic effects of fluoxetine should be emphasized as a probable etiologic factor. The phenomenon may be the equivalent of the serotonin reaction described in subjects with obsessive-compulsive & panic disorders rather than simply a paradoxical response in some patients. (4 refs.)