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Cited by 31Suicide and Self-Harm StudiesOpioid Use Disorder TreatmentPharmacovigilance and Adverse Drug Reactions

Non-psychotropic medication and risk of suicide or attempted suicide: a systematic review

Open access
Gorton, Hayley C, Webb, Roger T, Kapur, Navneet, Ashcroft, Darren M·2016·BMJ Open
DOI 10.1136/bmjopen-2015-009074PMC PMC4735210
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Abstract

OBJECTIVES: To establish which non-psychotropic medications have been assessed in relation to risk of suicide or attempted suicide in observational studies, document reported associations and consider study strengths and limitations. DESIGN: Systematic review. METHODS: Four databases (Embase, Medline, PsycINFO and International Pharmaceutical Abstracts) were searched from 1990 to June 2014, and reference lists of included articles were hand-searched. Case-control, cohort and case only studies which reported suicide or attempted suicide in association with any non-psychotropic medication were included. OUTCOME MEASURES: The outcomes eligible for inclusion were suicide and attempted suicide, as defined by the authors of the included study. RESULTS: Of 11,792 retrieved articles, 19 were eligible for inclusion. Five studies considered cardiovascular medication and antiepileptics; two considered leukotriene receptor antagonists, isotretinoin and corticosteroids; one assessed antibiotics and another assessed varenicline. An additional study compared multiple medications prescribed to suicide cases versus controls. There was marked heterogeneity in study design, outcome and exposure classification, and control for confounding factors; particularly comorbid mental and physical illness. No increased risk was associated with cardiovascular medications, but associations with other medications remained inconclusive and meta-analysis was inappropriate due to study heterogeneity. CONCLUSIONS: Whether non-psychotropic medications are associated with increased risk of suicide or attempted suicide remains largely unknown. Robust identification of suicide outcomes and control of comorbidities could improve quantification of risk associated with non-psychotropic medication, beyond that conferred by underlying physical and mental illnesses.

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  1. [49]Medicines and Healthcare Regulatory Authority. Review of isotretinoin and psychiatric adverse reactions. London: MHRA, 2014.

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Authors
Gorton, H. C., Webb, R. T., Kapur, N., & Ashcroft, D. M.
Affiliations
  • Manchester Academic Health Science Centre (GB)
  • University of Manchester (GB)
Corresponding author
Gorton, Hayley C
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2016-01
Volume
6
Issue
1
Pages
e009074
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2015-009074
PMC
PMC4735210
OpenAlex
W2284740959
Cited by
31
References
60
Citations by year
2025: 2 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 4 · 2017: 3 · 2016: 2 · 2015: 1
FWCI
0.69
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMJ Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion, cc-by)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
Keywords
suicide, suicide attempts, cardiovascular drugs, antiepileptic drugs, leukotriene receptor antagonists, isotretinoin, corticosteroids, antibiotics, varenicline, comorbidities, confounding, drug safety
MeSH terms
Varenicline, Adrenal Cortex Hormones, Anti-Bacterial Agents, Anticonvulsants, Cardiovascular Agents, Humans, Risk, Risk Factors, Suicide, Suicide, Attempted, Isotretinoin, Leukotriene Antagonists, Prescription Drugs, Observational Studies as Topic

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