In a recent study, researchers examined the link between medications and suicide risk.
For the last sixteen years, the rate of suicide has been increasing and has now reached the tenth-leading cause of death. Apart from psychiatric conditions, such as depression, that commonly lead to suicide attempts, it has been suggested that suicide could also be medication-induced. Because of this, the US Food and Drug Administration (FDA) requires a “black box” label for over 130 medications with little information about the suicide risk leaving the decision regarding the risks to prescribers and patients.
In a recent study, researchers identified medications that could increase the risk of suicide as well as drugs that might be helpful in suicide risk reduction. The results were published in the Harvard Data Science Review.
The research team analyzed records from 146 million patients who took any of the 922 prescribed drugs in the United States within a period spanning 2003 to 2014. The researchers calculated the number of suicide attempts in the three months prior to a medication prescription and in the three months following a medication prescription.
The researchers found that ten drugs had a statistically significant association with an increase in suicide attempts. This list includes such medications as the opioid painkiller hydrocodone bitartrate and acetaminophen (Vicodin), anti-anxiety medications alprazolam (Xanax) and diazepam (Valium), and the corticosteroid prednisone. However, forty-four drugs had the opposite effect and were associated with a decreased risk of suicide. These medications include a large group of antidepressants with a “black box” label, such as fluoxetine and escitalopram (Lexapro), and the anticonvulsant gabapentin (Neurontin) for the treatment of seizures, and medications which are used in the treatment of hypertension and Parkinson disease. In addition, the vitamin folic acid, often prescribed in pregnancy, was also associated with a reduction in suicide attempts.
Researchers hope that the new statistical model will help to discover the link between medications and suicide and help to determine which drugs to prescribe for patients with an increased suicidal risk. “What we’ve done is come up with an alternative approach to drug safety surveillance that could be used by any agency, country or formulary,” said Robert Gibbons, PhD, the Director of the Center for Health Statistics at the University of Chicago and lead author of the study. “We simultaneously did this analysis on all 922 drugs, and from that model, we can back out the risk for each one individually.”
Written by Anna Otvodenko
- Gibbons, R., Hur, K., Lavigne, J., Wang, J. and Mann, J. (2019). Medications and Suicide: High Dimensional Empirical Bayes Screening (iDEAS). 2.
- EurekAlert!. (2019). Study calculates links between prescription medications and risk for suicide. [online] Available at: https://www.eurekalert.org/pub_releases/2019-11/uoc-scl110519.php [Accessed 7 Nov. 2019].
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