Citation

Moller HJ. Clin. Neuropsychiatry 2011; 8(5): 277-286.

Copyright

(Copyright © 2011, Giovanni Fioriti Editore)

DOI

unavailable

PMID

unavailable

Abstract

This paper is a narrative review describing the place of antidepressants and other psychoactive medications in the treatment of suicidal ideation and behaviour associated with psychiatric disorders. Based on evidence as well as clinical experience, antidepressants have a prominent place in this indication, not only in depression but also in depressive syndromes in the context of other psychiatric disorders. The evidence for this is based on relatively few RCTs on the one side and on pharmacoepidemiological studies on the other side. Also anxiolytics and hypnotics are indicated, depending on the respective syndrome and disorder. However, for the latter medications the evidence in the sense of RCTs focussing on suicidality is widely missing. Of interest are data indicating that in schizophrenia, olanzapine might have a better suicidality preventive effect than other antipsychotics. Among the mood stabilizers there are hints from long-term studies predominantly in bipolar depression that lithium might prevent suicide. Altogether it has to be stated that the whole field needs more systematic research to increase the evidence base. Currently, it is to a large degree more dependent on clinical experience than on evidence. © 2011 Giovanni Fioriti Editore s.r.l.

Language: en

Keywords

human; suicide; suicidal ideation; Suicidality; schizophrenia; suicide attempt; Antidepressants; major depression; lithium; risk assessment; bipolar depression; clozapine; pharmacoepidemiology; posttraumatic stress disorder; risk factor; review; Psychopharmacology; antidepressant agent; anxiolytic agent; personality disorder; doxepin; amitriptyline; fluoxetine; paroxetine; serotonin uptake inhibitor; tricyclic antidepressant agent; venlafaxine; anxiety disorder; psychopharmacology; placebo; borderline state; carbamazepine; drug efficacy; olanzapine; benzodiazepine; valproic acid; drug effect; lamotrigine; hypnotic agent; evidence based medicine; adjustment disorder; obsessive compulsive disorder; drug indication