Pharmacological Treatment of Suicidal Behavior

  • Fabrizio Schifano
  • Diego De Leo


Suicidal Ideation Suicidal Behavior Personality Disorder Suicide Prevention Borderline Personality Disorder 
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  1. American Psychiatric Association. Practice guideline for major depressive disorder in adults. American Journal of Psychiatry, 1993; 150(suppl.): 1–26.Google Scholar
  2. Asberg M, Traskman M. Thoren P. 5-HIAA in the cerebrospinal fluid. A biochemical suicide predictor? Archives of General Psychiatry, 1976; 33: 1193–1197.PubMedGoogle Scholar
  3. Baldwin D, Bullock T, Montgomery D, Montgomery S. 5-HT reuptake inhibitors, tricyclic antidepressants and suicidal behavior. International Clinical Psychophatmacology, 1991; 6(suppl.): 49–55Google Scholar
  4. Ballenger NC, Post RM. Carbamazepine (Tegretol) in manic-depressive illness: a new treatment. American Journal of Psychiatry, 1980; 137: 782–790.PubMedGoogle Scholar
  5. Barraclough B. Suicide prevention, recurrent affective disorders and lithium. British Journal of Psychiatry, 1972; 121: 391–392.PubMedGoogle Scholar
  6. Barraclough B, Bunch J, Nelson B. A hundred cases of suicide: clinical aspects. British Journal of Psychiatry, 1974; 125: 355–373.PubMedGoogle Scholar
  7. Blumenthal SJ. Suicide: A guide to risk factors. assessment, and treatment of suicidal patients. Medical Clinics of North Anierica. 1988; 72: 937–962.Google Scholar
  8. Brinkley R, Beitman BD. Friedel RO. Low-dose neuroleptic regimen in the treatment of borderline patients. Archives of General Psychiatry, 1979; 36: 319–326.PubMedGoogle Scholar
  9. Buckley NA, Dawson AH, Whyte IM, Henry DA: Greater toxicity in overdose of dothiepin than of other tricyclic antidepressants. The Lancet, 1994; 343: 159–162.Google Scholar
  10. Cassidy S, Henry J. Fatal toxicity of antidepressant drugs in overdose. British Medical Journal, 1987 295: 1021–1024.PubMedGoogle Scholar
  11. Causemann B, Muller-Oerlinghausen B. Does lithium prevent suicides and suicide attempts? In Birch (editor) Lithium: inorganic pharmacology and psychiatric use, IRL Press, Oxford. 1988.Google Scholar
  12. Cohen LS, Winchel RM, Stanley M. Biological markers of suicide risk and adolescent suicide. Clinical Neuropharmacology, 1988; 1I: 423–435.Google Scholar
  13. Coppen A, Standish-Barry H, Bailey J, Houston G, Silcocks C, et al. Long-term lithium and mortality. Lancet, 1990; 335: 1347.CrossRefPubMedGoogle Scholar
  14. Cowdry RW. Gardner DL. Pharmacotherapy of borderline personality disorder. Archives of General Psychiatry, 1988: 45: I11–119.Google Scholar
  15. Crome P. The toxicity of drugs used for suicide. Acta Psychiatrica Scandinavica suppl, 1993: 371: 33–37.Google Scholar
  16. Dasgupta K, Hoover E. Additional cases of suicidal ideation associated with fluoxetine. American Journal of Psychiatry. 1990; 147: 1570–I57I.Google Scholar
  17. De Leo D, Marazziti D. Biological prediction of suicide: the role of serotonin. Crisis, 1988; 9: 109–118.PubMedGoogle Scholar
  18. De Wilde J, Mertens C. Fredricson Overo K, Hepfner Peterson HE. Citalopram versus mianserin. Acta Psychiatrica Scandinavica. 1985; 72: 89–96.PubMedGoogle Scholar
  19. Di Costanzo E, Schifano F. Lithium alone or in combination with carbamazepine for the treatment of rapid-cycling bipolar affective disorder. Acta Psychiatrica Scandinavica. 1991; 83: 456–459.PubMedGoogle Scholar
  20. Ennis J. Suicide prevention. Canadian Medical Association Journal, 1983: 129: 1078.Google Scholar
  21. Feighner JP. The role of venlafaxine in rational antidepressant therapy. Journal of Clinical Psychiatry, 1994; 55(9, suppl A): 62–68.PubMedGoogle Scholar
  22. Gaind R, Jacobi R. Benzodiazepines causing aggression. In Gaind, Hudson (Eds) Current Themes in Psychiatry, Publishing Company, London, 1978.Google Scholar
  23. Gardner DL, Cowdry RW. Alprazolam-induced dyscontrol in borderline personality disorder. American Journal of Psychiatry, 1985; 142: 98–100.PubMedGoogle Scholar
  24. Gardner DL, Cowdry RW. Positive effects of carbamazepine on behavioral dyscontrol in borderline personality disorder. American Journal of Psychiatry, 1986; 143: 519–522.PubMedGoogle Scholar
  25. Gasperini M, Gatti F, Bellini L, Anniverno R, Smeraldi E. Perspectives in clinical psychopharmacology of aniitryptyline and fluvoxamine: a double-blind study in depressed inpatients. Neuropsychobiology, 1992; 26: 186–192.PubMedGoogle Scholar
  26. Gonella G, Baignoli G, Ecari V. Fluvoxamine and imipramine in the treatment of depressive patients: a double-blind controlled study. Current Medical Research and Opinion. 1990; 12: 177–184.PubMedGoogle Scholar
  27. Guze SB, Robins E. Suicide and primary affective disorders. British Journal of Psychiatry, 1970; 117: 437–438.PubMedGoogle Scholar
  28. Hendin H. Psychodynamics of suicide, with particular reference to the young. American Journal of Psychiatry. 1991; 148: 1150–1157.PubMedGoogle Scholar
  29. Hoover CE. Suicidal ideation not associated with fluoxetine. American Journal of Psychiatry. 1991; 148: 543.PubMedGoogle Scholar
  30. King RA, Riddle MA. Chappell PB. Emergence of self-destructive phenomena in children and adolescents during fluoxetine treatment. Journal of American Academy of Child and Adolescent Psychiatry, 1991; 30: 179–186.Google Scholar
  31. Kjelsberg E, Eikeseth PH, Dahl AA. Suicide in borderline patients: predictive factors. Acta Psychiatrica Scandinavica, I991: 84: 283–287.Google Scholar
  32. Lipinski JF, Mallya G, Zimmerman P, Pope HG. Fluoxetine-induced akathisia: clinical and theoretical implications. Journal of Clinical Psychiatry, 1989; 50: 339–342.PubMedGoogle Scholar
  33. Lopez-Ibor JJ jr. Reduced suicidality with paroxetine. European Psychiatry. 1993; 8(suppl. 1): 17s–19s.Google Scholar
  34. Lowenstein SR. Suicidal behavior: recognition and intervention. Hospital Practice, 1985; 10: 52–71.Google Scholar
  35. Mann JJ, Goodwin K, O’Brien C, Robinson DS. Suicidal behavior and psychotropic medication. Neuropsychophamacology, 1993; 8: 177–183.Google Scholar
  36. Mann JJ, Kapur S. The emergence of suicidal ideation and behavior during antidepressant pharmacotherapy. Archives of General Psychiatry. 1991: 48: 1027–1032.PubMedGoogle Scholar
  37. Maric MM. Criteria for selection of first choice antidepressive agents. Ceskoslovenska Psychiatrica, 1992; 88: 220–224.Google Scholar
  38. Masand P, Gupta S, Dewan M. Suicidal ideation related to fluoxetine treatment. New England Journal of Medicine, 1991; 324: 420.PubMedGoogle Scholar
  39. Mattes JA. Carbamazepine for uncontrolled rage outbursts. Lancet, 1984; 2: 1164–1165.PubMedGoogle Scholar
  40. Mendelson WB. Rich CL. Sedatives and suicide: the San Diego study. Acta Psychiatrica Scandinavica, 1993; 88: 337–341.PubMedGoogle Scholar
  41. Michel K, Arestegui G. Spuhler T. Suicide with psychotropic drugs in Switzerland. Pharmacopsychiatry, 1994; 27: 114–118.PubMedGoogle Scholar
  42. Michel K, Waeber W, Valach L, Arestegui G, Spuhler T. A comparison of the drugs taken in fatal and nonfatal self-poisoning. Acta Psychiatrica Scandinavica, 1994; 90: 184–189.PubMedGoogle Scholar
  43. Miles D. Conditions predisposing to suicide: a review. Journal of Nervous and Mental Diseases, 1977; 164: 231–246.Google Scholar
  44. Modestin J, Schwarzenbach F. Effect of psychopharmacotherapy on suicide risk in discharged psychiatric inpatients. Acta Psychiatrica Scandinavica, 1992: 85: 173–175.PubMedGoogle Scholar
  45. Moller HJ, Fuger J, Kasper S. Efficacy of new generation antidepressants: meta-analysis of imipramine-controlled studies. Pharmacopsychiatry, 1994: 27: 215–223.PubMedGoogle Scholar
  46. Montgomery SA. Depression in the elderly: pharmacokinetics of antidepressants and deaths from overdose. International Clinical Psychophamiacology, 1990; 5: 67–74.Google Scholar
  47. Montgomery SA, McAuley R, Rani SJ, Roy D, Montgomery DB. A double-blind comparison of zimelidine and amitriptyline in endogenous depression. Acta Psychiatrica Scandinavica, 198I; 290(suppl.): 314–327.Google Scholar
  48. Montgomery SA. Montgomery DB. Pharmacological prevention of suicidal behavior. Journal of Affective Disorders, 1982; 4: 291–298.CrossRefPubMedGoogle Scholar
  49. Montgomery SA, Montgomery DB. The prevention of suicidal acts in high risk patients. In Usdin (editor) Frontiers in biochemical and pharmacological research in depression. Raven Press, New York, 1984.Google Scholar
  50. Montgomery SA, Montgomery DB, Rani SJ. Roy DH, Shaw PJ. Maintenance therapy in repeat suicidal behavior: a placebo-controlled trial. 10th International Congress for Suicide Prevention, Ottawa. 1979.Google Scholar
  51. Montgomery DB, Roberts A, Green M, Bullock T. Baldwin D, Montgomery SA. Lack of efficacy of fluoxetine in recurrent brief depression and suicidal attempts. European Archives of Psychiatry and Clinical Neuroscience, 1994: 244: 211–215.CrossRefPubMedGoogle Scholar
  52. Muijen M, Roy D, Silverstone T, Mehmet A, Christie M. A comparative clinical trial of fluoxetine, mianserin and placebo in depressed outpatients. Acta Psychiatrica Scandinavica, 1988; 78: 384–390.PubMedGoogle Scholar
  53. Muller-Oerlinghausen B, Ahrens B, Grof E, Grof P, Lenz G. et al. The effect of long-term lithium treatment on the mortality of patients with manic-depressive and schizoaffective illness. Acta Psychiatrica Scandinavica, 1992; 86: 218–222.PubMedGoogle Scholar
  54. Muller-Oerlinghausen B, Kossmann B, Volks J, Hermann H. Frequency, quality and temporal pattern of relapses during ten years of lithium prophylaxis. In Birch (editor) Lithium: inorganic pharmacology and psychiatric use, IRL Press, Oxford, 1988.Google Scholar
  55. Mullin JM, Pandita-Gunawardena VR, Whithead AM. A double-blind comparison of fluvoxamine and dothiepin in the treatment of major affective disorders. British Journal of Clinical Practitioner, 1988; 42: 51–55.Google Scholar
  56. Murphy GE. Clinical indication of suicidal risk. Archives of General Psychiatry, 1972; 27: 356–359.PubMedGoogle Scholar
  57. Murphy GE. The prediction of suicide: why is it so difficult? American Journal of Psychotherapy, 1984; 38: 341–349.PubMedGoogle Scholar
  58. Murphy GE. The physician’s role in suicide prevention. In Roy (editor) Suicide, Williams & Wilkins, Baltimore, 1986.Google Scholar
  59. Ojehagen A, Regnell G, Trasknian-Bendz L. Deliberate self-poisoning: repeaters and nonrepeaters admitted to an intensive care unit. Acta Psychiatrica Scandinavica, 1991; 84: 266–271.PubMedGoogle Scholar
  60. Okuma T, Inanaga K, Otsuki S. A preliminary double-blind study of the efficacy of carbamazepine in prophilaxis of manic-depressive illness. Psychopharmacology, 1981; 73: 95–96.CrossRefPubMedGoogle Scholar
  61. Ottevanger EA. Fluvoxamine superior to imipramine in suicidal depressed patients. European Neuropsychophamiacology, 1993; 3(3, special issue): 362–363.Google Scholar
  62. Pary R, Lippmann S, Turns DM, Tobias CR. Drug selection after overdose recovery: carbamazepine or lithium. Journal of Kentucky Medical Association. 1987: 85: 21–23.Google Scholar
  63. Pokomy AD. Suicide rates in various psychiatric disorders. Journal of Nervous and Mental Diseases, 1964; 139: 499–506.Google Scholar
  64. Power AC, Cowen PJ. Fluoxetine and suicidal behaviour: some clinical and theoretical aspects of a controversy. British Joumal of Psychiatry, 1992; 161: 735–741.Google Scholar
  65. Preskorn SH, Burke M. Somatic therapy for major depressive disorder: selection of an antide-pressant. Journal of Clinical Psychiatry, 1992: 53(suppl.): 5–16.PubMedGoogle Scholar
  66. Rao ML, Braunig P, Papassotiropoulos A. Autoaggressive behavior is closely related to serotonin availability in schizoaffective disorder. Pharmacopsychiatry, 1994; 27: 202–206.PubMedGoogle Scholar
  67. Robins E, Murphy GE, Wilkinson RM. Some clinical considerations in the prevention of suicide based on a study of 134 successful suicides. American Journal of Public Health, 1959; 49: 888–898.PubMedGoogle Scholar
  68. Roose SP, Glassman AH, Attia E. Woodring S. Comparative efficacy of selective serotonin reuptake inhibitors and tricyclics in the treatment of melancholia. American Journal of Psychiatry, 1994; 151: 1735–1739.PubMedGoogle Scholar
  69. Rouillon F, Phillip R, Serrurier D, Ansart E, Gerard MJ. Rechutes de depression unipolaire et efficacite de la maprotiline. Encephale. 1989: 15; 527–534.PubMedGoogle Scholar
  70. Sacchetti E, Vita A, Guarneri L, Cornacchia M. The effectiveness of fluoxetine, clomipramine. nortriptyline and desipramine in major depressives with suicidal behaviour: preliminary findings. In Cassano. Akiskal (editors) Serotonin-related psychiatric syndromes: clinical and therapeutic links, No. 165, pp. 47–53, Royal Society of Medicine Services Limited, London, 1991.Google Scholar
  71. Salzmann C, Kochansky GE, Shader RI, Porrino LJ, Harmatz JS, et al. Chlordiazepoxide-induced hostility in a small group setting. Archives of General Psychiatry, 1974; 31: 401–405.Google Scholar
  72. Schifano F, De Leo D: Can phamiacological intervention aid in the prevention of suicidal behavior’? Pharmacopsychiatry, 1991; 24: 113–117.PubMedGoogle Scholar
  73. Schifano F, Magni G. Corfini A. Antidepressivi e apparato cardiovascolare. Aspetti farmacologici e clinici. Quademi Italiani di Psichiatria, 1991; 10: 221–244.Google Scholar
  74. Schifano F. Pharmacological strategies for preventing suicidal behaviour. CNS Drugs, 1994; 1: 16–25Google Scholar
  75. Song F, Freemantle N, Sheldon TA, House A, Watson P, et al. Selective serotonin reuptake inhibitors: meta-analysis of efficacy and acceptability. Britis Medical Journal, 1993; 306: 683–686.Google Scholar
  76. Taiminen TJ. Effect of psychopharmacotherapy on suicide risk in psychiatric inpatients. Acta Psychiatrica Scandinavica, 1993; 87: 45–47.PubMedGoogle Scholar
  77. Thase ME. Long-term treatment of recurrent depressive disorders. Journal of Clinical Psychiatry, 1992; 53(suppl.): 32–41.PubMedGoogle Scholar
  78. Teicher MH, Glod C, Cole JO. Emergence of intense suicidal preoccupation during fluoxetine treatment. American Journal of Psychiatry, 1990; 147: 207–210.PubMedGoogle Scholar
  79. Traskman L, Asberg M, Bertilsson L, Sjostrand L. Monoamine metabolites in cerebrospinal fluid and suicidal behavior. Archives of General Psychiatry, 1981; 38: 631–636.PubMedGoogle Scholar
  80. Van Praag HM. Psychobiology of suicidal behavior. Annals of New York Academy of Sciences, 1986; 487: 150–167.Google Scholar
  81. Vetro A, Pallag P. Szentistvanyl LI, Vargha M. Szilard J. Treatment of childhood aggressivity with lithium. Aggressologie, 1981; 22: 27–30.Google Scholar
  82. Volk J, Muller-Oerlinghausen B. Quality of interepisodic periods in patients with affective disorders under long-term lithium treatment. Pharmacopsychiatry, 1988; 21: 426–427.PubMedGoogle Scholar
  83. Waddington D, McKenzie IP. Overdose rates in lithium-treated versus antidepressant-treated outpatients. Acta Psychiatrica Scandinavica, 1994; 90: 50–52.PubMedGoogle Scholar
  84. Winokur A, Rickels K, Greenblatt DJ. Snyder PJ, Schatz NJ. Withdrawal reaction from longterm, low dosage administration of diazepam. Archives of General Psychiatry, 1980; 37: 101–105.PubMedGoogle Scholar
  85. Wirshing W, Van Putten T, Rosenberg J. Marder S, Ames D, et al. Fluoxetine. akathisia, and suicidality: is there a causal connection’? Archives of General Psychiatry. 1992; 49: 580–581.PubMedGoogle Scholar
  86. Wolfersdorf M. The value of psychotropic drugs in treatment of suicidal behavior. Psychiatrische Praxis, 1992; 19: 100–107.PubMedGoogle Scholar

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© Kluwer Academic Publishers 1998

Authors and Affiliations

  • Fabrizio Schifano
  • Diego De Leo

There are no affiliations available

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