Psychotropic medications successfully combat symptoms of
depression, anxiety and psychosis but fail spectacularly in reducing one
crucial index of mental illness: suicide.
By
Kaja Perina, published on October 01, 2002
Psychotropic medications successfully combat symptoms of
depression, anxiety and psychosis but fail spectacularly in reducing one
crucial index of mental illness: suicide. A review of more than 71,000
patients in clinical trials of 52 psychotropic medications found an equal
risk of suicide among those assigned medication and those taking
placebos.
"Suicide may not be connected to alleviating symptoms [of mental
illness]," says Arif Khan, M.D., medical director of the Northwest
Clinical Research Center in Bellevue, Washington. "It is a complex
behavior, much more complicated than the treatments for mental
illness."
Khan reviewed Food and Drug Administration (FDA) reports on
psychotropic drugs approved between 1985 and 2000 and calculated that the
risk of suicide-11 per 100,000 in the general population-jumps to 752 per
100,000 in antipsychotic trials and 655 per 100,000 in trials of
antidepressants. Khan also reviewed anti-panic, anti-anxiety and
anti-obsessional agents. No class of medication showed a significant
difference in the risk of suicide or attempted suicide among patients
assigned to trial medication, FDA-approved medication or placebo.
Because clinical trials exclude patients thought to be at risk for
suicide, or those suffering from comorbid mental illness, the rate of
suicide calculated by Khan is surprisingly high. However, in general
patients on placebos tend to drop out of trials earlier than those on
medication, comparatively elevating the rate of suicide among patients
taking psychotropic medication.
"Further research to identify psychotropics or other treatments
that reduce suicide risk is essential," says Khan, who presented his
findings at the New Clinical Drug Evaluation Unit, an annual meeting
sponsored by the National Institute of Mental Health.
The atypical antipsychotic clozapine (marketed as Clozaril), is the
sole medication currently under review by the FDA for use as an
anti-suicidal agent.
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