Relationship Between Risk for Suicide and Prescription Drugs

Columbia Psychiatry: Rates of suicide in the United States have been steadily rising for the past 16 years. Which prescription drugs show a statistically significant increase in suicide attempts?

Dr. Mann: 10 out of 922 drugs evaluated showed increased risk. Among the strongest increased risk signals identified were alprazolam, butalbital, hydrocodone, and the codeine/promethazine mixture.

Columbia Psychiatry: On the contrary, how many drugs had an association with a decrease in suicide risk?

Dr. Mann: 44 drugs showed lower risk. The list includes a large group of FDA approved antidepressants: selective serotonin reuptake inhibitor (SSRI) antidepressants citalopram, escitalopram, fluoxetine, and sertraline; the mixed serotonin and norepinephrine reuptake inhibitors (SNRI) venlafaxine, desvenlafaxine, and duloxetine; bupropion, an aminoketone that inhibits norepinephrine reuptake; mirtazapine, a noradrenergic alpha2-adrenergic antagonist; trazodone, a serotonin 5-HT2A receptor antagonist and reuptake inhibitor; and the tricyclic doxepin. The list also contains several antipsychotic medications and the vitamin folic acid, to name a few.

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