Suicidality and side effects of antidepressants and antipsychotics

Psychiatr Danub. 2010 Mar;22(1):79-84.

Abstract

Antidepressants and antipsychotics can cause side effects in various organs and organic systems, and some (and) in the central nervous system, which can also be clinically manifested by suicidal behavior as well. Tricyclic antidepressants particularly of imipramine and clomipramine can have pro-suicidal effect, which is believed to be the consequence of their own hypothetic asynchronous cognitive-psychomotor pharmacodynamic action. Antidepressants from the group of selective serotonin reuptake inhibitors can at the beginning of administration as monotherapy also have pro-suicidal effects in patients with hints of suicidality or suicidal behavior, by increasing the intensity of already present suicidal predictors, such as dysphoria, anxiety, impulsiveness, agitation etc. Antipsychotics can act stimulatingly upon predictors of suicidal behavior, that is, pro-suicidal in an indirect way through side effects they cause indirect pro-suicidal neurological and consecutive psychological impact, as it is called. It is particularly valid for classic antipsychotics causing primarily neurological, i.e. extrapyramidal side effects, along which consecutive psychological side effects can occur as well. However, new antipsychotics in comparison to classic ones, have less pronounced neurological, extrapyramidal symptoms and signs but more somatic-metabolic side effects, and thereby their action can be mostly manifested as indirect pro-suicidal neurological and somatic-metabolic as well as consecutive psychological activity.

Publication types

  • Review

MeSH terms

  • Aged
  • Antidepressive Agents / adverse effects*
  • Antidepressive Agents / therapeutic use
  • Antidepressive Agents, Tricyclic / adverse effects
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Cross-Sectional Studies
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / epidemiology
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Male
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / psychology
  • Risk Factors
  • Selective Serotonin Reuptake Inhibitors / adverse effects
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Suicide / psychology
  • Suicide / statistics & numerical data*
  • Suicide, Attempted / psychology
  • Suicide, Attempted / statistics & numerical data*

Substances

  • Antidepressive Agents
  • Antidepressive Agents, Tricyclic
  • Antipsychotic Agents
  • Serotonin Uptake Inhibitors