Assessing the Role of Drugs in Suicidal Ideation and Suicidality

Reith, David; Edmonds, Liza

doi:10.2165/00023210-200721060-00003

Cited by 35 publications

(26 citation statements)

References 64 publications

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“…Other studies show a nicotine antagonist can act as an antidepressant (George et al 2008). Although debatable, some lines of evidence suggest antidepressants increase suicide risk in adults (Mann et al 2006; Licinio & Wong 2005; Reith & Edmonds 2007). The mechanisms by which antidepressants might increase suicide are unclear; e.g., antidepressants might induce akathesia, aggression, panic attacks, mania, or obsessions (Teicher et al 1993).…”

Section: Resultsmentioning

confidence: 99%

Smoking and suicide: A brief overview

Hughes

2008

Drug and Alcohol Dependence

216

132

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This article provides a brief overview of the rationales, possible mechanisms and epidemiological data on the association of smoking, smoking cessation and cessation medications with suicide. Current smoking is reliably associated with suicide both in case-control and cohort studies. The three most plausible (but relatively untested) explanations for the association are that smokers have pre-existing conditions that increase their risk for suicide, smoking causes painful and debilitating conditions that might lead to suicide, and smoking decreases serotonin and monoamine oxidase levels. Stopping smoking appears to lead to major depression in some smokers; thus, it could induce suicide; however, smoking cessation has not been associated with suicide in the few studies available. Regulatory agencies have stated bupropion, rimonabant and varenicline appear to be associated with suicide; however, the data for these statements have not been presented in sufficient detail to assess their validity. Most prior data have come from post-hoc analyses. Studies that a priori focus on understanding smoking and suicide are now needed.

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Section: Resultsmentioning

confidence: 99%

Smoking and suicide: A brief overview

Hughes

2008

Drug and Alcohol Dependence

216

132

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“…There is some ambiguity with defining terms related to suicide and suicidal behaviour, making it difficult to compare studies and conduct a meta-analysis [19]. Most clinicians and researchers distinguish suicidal behaviour from non-suicidal self-injury, i.e.…”

Section: Methodsmentioning

confidence: 99%

Asthma and suicide-related adverse events: a review of observational studies

Iessa¹,

Murray²,

Curran³

et al. 2011

European Respiratory Review

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Suicide is a major public health concern. There are several risk factors associated with suicide. Chronic illnesses, such as asthma, have been linked to an increased risk of suiciderelated events. This study reviews the evidence of an association between asthma and suicide using published epidemiological observational studies.An electronic search using PubMed and EMBASE was performed. Studies that investigated the association of asthma with suicide-related behaviour were selected. Studies were examined to form a descriptive analysis.Six observational studies met the selection criteria, of which at least one suicide-related adverse event was studied. Three studies investigated completed suicide, two suicide attempts and four suicide ideation. Two of the studies focused on individuals aged ,18 yrs.Evidence from observational data support the hypothesis of an association between asthma and suicide-related behaviour (ideation, attempts and completion); however, epidemiological studies, with more objective measures and larger sample sizes, adjusting for a wider scope of suicide-related confounding factors (e.g. comorbidities), and with a longitudinal design, are needed for a more conclusive answer.

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“…Observational studies may generate hypotheses but are complicated by a number of confounding factors, some of which are not assessed. In clinical trials that use adverse events as the measure of suicidality, suicidal behavior or ideation may not be captured 44. However, clinical trials that collect information on suicidality in a standardized fashion at selected time intervals would be ideal to answer these questions, even if these are secondary analyses.…”

Section: What’s the Role Of These Data In Clinical Practice?mentioning

confidence: 99%

Suicidal behavior and antiepileptic drugs in epilepsy: analysis of the emerging evidence

Mula¹

2011

DHPS

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Two years after the warning issued by the Food and Drug Administration on an increased risk of suicide for people taking antiepileptic drugs (AEDs), a number of pharmacoepidemiologic studies have been published but the scientific community is far from definitive answers. The present paper is aimed at reviewing available evidence on the association between AEDs and suicidal behavior, discussing major variables involved such as the relationship between epilepsy, depression, and suicide and the psychotropic potential of AEDs. All studies published so far show a lack of concordance and are constrained by various methodological limitations. What seems to be established is that mood disorders represent a frequent comorbidity in epilepsy and suicide is a serious complication more frequently encountered in epilepsy rather than in the general population. Moreover, a subgroup of patients appears to be at risk of developing treatment-emergent psychiatric adverse effects of AEDs independently of the specific mechanism of action of the drug. The prior history of suicide attempt, especially preceding the onset of the epilepsy, may represent a key element explaining why what is observed is independent of the specific mechanism of the drug. In general terms, risks associated with stopping, or not even starting, AEDs in epilepsy might well be in excess of the risk of suicide in epilepsy, as deaths due to accident and epilepsy itself may predominate. Clinicians need to pay attention not only to seizure patterns when choosing the appropriate AED but also to a number of different parameters (eg, age, gender, working needs, medical comorbidities, history of psychiatric disorders, and suicidality before epilepsy onset) and not the least the mental state of the patient. Missing severe complications such as suicidal behavior or delaying its treatment may worsen the prognosis of epilepsy.

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Assessing the Role of Drugs in Suicidal Ideation and Suicidality

Cited by 35 publications

References 64 publications

Smoking and suicide: A brief overview

Smoking and suicide: A brief overview

Asthma and suicide-related adverse events: a review of observational studies

Suicidal behavior and antiepileptic drugs in epilepsy: analysis of the emerging evidence

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