Evidence to associate exposure to organophosphate (OP) pesticides with the development of affective disorders and suicidal behaviour is reviewed. It is concluded on the basis of neurotoxicological studies, clinical reports and experience, and epidemiological work that such a relationship does exist and that chronic exposure to OP pesticides not only confers increased vulnerability to affective disorder and suicide but also directly induces mood destabilization in individuals otherwise at low risk of these disorders. It is recommended that a moratorium on the use of OP insecticides be declared until definitive research to establish the riskhenefit balance with regard to affective disorders, suicide and the broader range of reported adverse effects on health is completed. Gorman JM, Liebowitz MR, Fyer AJ et al. An open trial of fluoxetine in the treatment of panic attacks. J Clin Psychopharmacol 1987; 7: 329-32. J Nutr Environ Med Downloaded from informahealthcare.com by University of Otago on 01/04/15 For personal use only.