I take it for fibromyalgia to damp down pain responses. When I started getting really bad shooting pains in my limbs as a side effect of methotrexate I take for rheumatoid arthritis I was told to double it that evening then triple it a couple of days after.
I doubled it and started getting suicidal thoughts but, although I was just prescribed it by a rheumatology registrar without being told anything about it, I had read up on it a lot myself so I knew it was a potential side effect.
It was very strange, I just kept seeing ways to kill myself everywhere, knives, the oven, the bath... I was rational enough to attribute it to the drugs and just went to bed to sleep through it.
I then dropped down to 3 tablets (1.5 x original dose) for a few days then, rather tentatively, went up to 2. That went ok but have never dared going up further.
I did think of what could happen for people who weren't aware of the potential side effects or couldn't rationalise.
But it's a rare side effect and the benefit of taking it for me outweighed the side effects I read about. Similar the potential significant weight gain - I piled on weight twice, when starting then when it was increased, same as when I started mirtazapine (I wasn't told of the potential effects but I read up) and steroids. The benefit for me has outweighed it.
Many side effects are listed as precautionary and I imagine defensively to try to avoid litigation. I like to be informed but I take little notice of the rafts of potential side effects listed unless they effect me badly enough that it outweighs the benefit of taking them.