Which medication should be prioritized for a patient with major depressive disorder experiencing suicidal ideation?

For a patient with major depressive disorder who is experiencing suicidal ideation, the prioritized medication is selective serotonin reuptake inhibitors (SSRIs). SSRIs are commonly prescribed as the first-line treatment for major depressive disorder due to their favorable side effect profile and established efficacy in treating depression. Their mechanism of action involves the increase of serotonin levels in the brain, which can improve mood and reduce feelings of hopelessness, thereby addressing symptoms that may be associated with suicidal thoughts.

In addition, SSRIs are generally considered safer than other classes of antidepressants, particularly in overdose situations, which is a critical consideration for patients with suicidal ideation. This safety profile makes SSRIs a more preferable choice compared to other options like tricyclic antidepressants, which can pose a higher risk of toxicity in overdose situations.

Furthermore, while antipsychotics and mood stabilizers may have their place in certain treatment scenarios, they are typically not first-line treatments for major depressive disorder. Their use is more common in cases where there are co-occurring conditions such as bipolar disorder or psychosis. Therefore, SSRIs remain the most appropriate and effective first choice for managing major depression, especially in patients at risk for suicide.