Psychopharmacological treatment before suicide attempt among patients admitted to a Psychiatric Intensive Care Unit

Abstract

Background It is difficult to assess the effectiveness of treatments in lowering suicide incidence. Methods To ascertain the impact of antidepressants (AD) on suicidal behavior, we compared the psychopharmacological treatment taken in the previous 3 months by cases who had made or not a suicide attempt (SA) just before their admission to a hospital. Results In comparison with not SA cases, SA cases were more likely to have received AD and benzodiazepines (BZD) before hospitalization. On the contrary, they were less likely to have received antipsychotics, antiepileptic mood stabilizers, and lithium. Similar results were observed when the analysis was restricted to cases with a diagnosis of Major Depression, Bipolar Depression or Bipolar Mixed state, Schizoaffective Disorder, Depressive or Mixed type. Previous AD treatment seemed to be not related to the severity of psychopathology in general or to the severity of depressive and anxiety symptoms. Conclusions The results suggest that the use of AD in patients with mood disorders is not associated with a reduction of SA rate. Rather, it is not possible to exclude that AD or BZD can induce, worsen, or precipitate suicidal behavior in some patients, especially in those affected by mood disorders with Depressive or Mixed features. The results must be considered preliminary since this is an open, non-randomized, non-controlled study that was carried out at a single facility.