Cited by 71Bipolar Disorder and TreatmentSuicide and Self-Harm StudiesTreatment of Major Depression

Suicidal Behavior in Mood Disorders: Response to Pharmacological Treatment

Tondo, Leonardo, Baldessarini, Ross J.·2016·Current Psychiatry Reports

Abstract

Suicidal behavior is strongly associated with depression, especially if accompanied by behavioral activation, dysphoria, or agitation. It may respond to some treatments, but the design of scientifically sound, ethical trials to test for therapeutic effects on suicidal behavior is highly challenging. In bipolar disorder, and possibly also unipolar major depression, an underprescribed medical intervention with substantial evidence of preventive effects on suicidal behavior is long-term treatment with lithium. It is unclear whether this effect is specifically antisuicidal or reflects beneficial effects of lithium on depression, mood instability, and perhaps aggression and impulsivity. Antisuicidal effects of anticonvulsant mood stabilizers (carbamazepine, lamotrigine, valproate) appear to be less than with lithium. Further evaluation is needed for potential antisuicidal effects of atypical antipsychotics with growing evidence of efficacy in depression, particularly acute bipolar depression, while generally lacking risk of inducing agitation, mania, or mood instability. Short-term and long-term value and safety of antidepressants are relatively secure for unipolar depression but uncertain and poorly tested for bipolar depression; their effects on suicidal risk in unipolar depression may be age-dependent. Sedative anxiolytics are virtually unstudied as regards suicidal risks. Adequate management of suicidal risks in mood disorder patients requires comprehensive, clinically skillful monitoring and timely interventions.

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Crossref · 10.1007/s11920-016-0715-0

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Authors
Tondo, L., & Baldessarini, R. J.
Affiliations
Harvard University (US)
Corresponding author
Tondo, Leonardo
Venue
Current Psychiatry Reports
Published
2016-08-20
Volume
18
Issue
9
Pages
88-88
ISSN
  • 1523-3812 (ISSN-L)
  • 1535-1645
OpenAlex
W2516851151
Cited by
71
References
124
Citations by year
2026: 1 · 2025: 2 · 2024: 7 · 2023: 4 · 2022: 12 · 2021: 4 · 2020: 6 · 2019: 3 · 2018: 22 · 2017: 8 · 2016: 2
FWCI
1.66
Type
journal article
Language
en
Open access
closed
Locations
  • Current Psychiatry Reports (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Keywords
suicidal behavior, mood disorders, depression, bipolar disorder, bipolar depression, lithium, antisuicidal effects, mood stabilizers, antiepileptic drugs, carbamazepine, lamotrigine, valproic acid, atypical antipsychotics, antidepressants, suicide risk, suicide prevention, treatment response
MeSH terms
Suicide Prevention, Behavioral Symptoms, Drug Therapy, Humans, Psychotropic Drugs, Suicide, Treatment Outcome, Mood Disorders, Risk Adjustment, Suicidal Ideation

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