Atypical antipsychotics and suicide
in mood and anxiety disorders
by
Sharma V.
Mood Disorders Program,
Regional Mental Health Care London,
Department of Psychiatry,
University of Western Ontario,
London, Ontario, Canada.
vsharma@uwo.ca
Bipolar Disord. 2003;5 Suppl 2:48-52

ABSTRACT

Globally, a million people commit suicide every year, and 10-20 million attempt it. Mood disorders, especially major depressive disorder (MDD) and bipolar disorder, are the most common psychiatric conditions associated with suicide. Primary (psychiatric and physical illness), secondary (psychosocial), and tertiary (demographic) risk factors for suicide have been identified. Comorbid psychiatric illness, particularly anxiety symptoms or disorders, significantly increase the risk of suicidal behavior. Current standard risk assessments and precautions may be of limited value, while assessing the severity of anxiety and agitation may be more effective in identifying patients at risk. Lithium is the medication that has most consistently demonstrated an antisuicidal effect. The effects of antidepressants and conventional antipsychotics on suicide risk are uncertain, but atypical antipsychotics appear promising. Atypical antipsychotics have beneficial effects on depressed mood both in patients with MDD and in patients with bipolar disorder. In addition, data in patients with schizophrenia have demonstrated a significant improvement in the incidence of suicidal behavior with clozapine compared with olanzapine. Electroconvulsive therapy appears to have an acute benefit on suicidality.

Suicide
Deliriants
Quetiapine
Olanzapine
Amisulpride
Trimipramine
Antipsychotics
Chlorpromazine
The deficit syndrome
Antipsychotics: review
Schizoaffective disorder
Schizophrenia: new drugs
Bipolars and schizophrenics
Atypical antipsychotic agents
Are atypicals antidepressants?
Partial dopamine agonists for psychosis
Big Pharma and drugs for schizophrenics
Atypical antipsychotics for schizophrenia
5-HT2a inverse agonists as antipsychotics
Atypicals versus traditional antipsychotics

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