Published: February 2010

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Suicidality - a rare adverse effect

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Prescriber Update 31(1): 7
February 2010

Prescribers are reminded of the rare adverse effect of suicidality that is associated with a number of medicines used in New Zealand.

The Oxford Textbook of Psychiatry identifies suicidality as suicidal behaviour ranging from suicidal ideation to suicide attempt and completed suicide.¹ It may not always be clear whether suicidality is related to the use of a medicine or the underlying condition.

CARM has received a number of reports of suicidality in New Zealand associated with the use of specific medicines.  The most common classes of medicines mentioned in the reports include, but are not limited to, antidepressants, antiepileptics, antipsychotics, anxiolytics, interferons and retinoids.

Healthcare professionals are encouraged to refer to medicine data sheets where possible to determine whether a patient may be at risk of suicidality. All patients who are taking or starting a medicine that has been associated with suicidality should be monitored for changes in behaviour that could indicate the emergence or worsening of depression, suicidal thoughts and/or suicidal behaviour.

Healthcare professionals are reminded to inform patients, and with the patient’s consent, their families and caregivers of an increased risk of suicidality with some medicines.  Patients should be advised to seek medical advice immediately if they experience changes in mood or behaviour that may be suggestive of suicidality.

References

1. Gelder M et al. 2000. New Oxford Textbook of Psychiatry (1^st Ed). Great Britain: Oxford University Press.