Depression is associated with increased risk of suicidal thoughts, self-harm and suicide (suicide-related events). This risk persists until significant remission occurs. Patients with history of suicide-related events, or those exhibiting a significant degree of suicidal ideation prior to commencement of treatment are at greater risk of suicidal thoughts or suicide attempts. EMS reported in association with use of oral L-tryptophan-containing products; this is a usually reversible, rarely fatal multisystem disorder. Symptoms of EMS reported to include eosinophilia, arthralgia or myalgia, fever, dyspnea, neuropathy, peripheral edema and skin lesions which can include sclerosis or papular and urticarial lesions. Caution should be exercised with patients who experience some but not all of the symptoms of EMS after taking L-tryptophan. Treatment should be withheld and symptoms investigated until possibility of EMS can be excluded. Possible interaction between L-tryptophan and 5-HT reuptake inhibitors could lead to «serotonin syndrome», characterized by a combination of agitation, restlessness and GI symptoms including diarrhea. Combinations with 5-HT reuptake inhibitors should only be used with care.