Study Links Medications to Suicide Risk

Growing Concern Over Suicide Rates

Recent research has highlighted the connection between certain medications and the risk of suicide. Over the last sixteen years, suicide rates have risen significantly, now ranking as the tenth-leading cause of death in the United States. While psychiatric conditions, such as depression, are often associated with suicide attempts, there is increasing evidence suggesting that some medications may also contribute to this risk.

FDA Warnings and Medication Risks

In response to these concerns, the U.S. Food and Drug Administration (FDA) has mandated a “black box” warning for over 130 medications. However, these warnings provide limited information regarding suicide risks, leaving prescribers and patients to navigate the potential dangers on their own.

Research Findings Published

A recent study, published in the Harvard Data Science Review, sought to identify specific medications linked to increased suicide risk, as well as those that could potentially mitigate it. The research team examined records from 146 million patients who were prescribed any of the 922 medications in the United States between 2003 and 2014. They analyzed the incidence of suicide attempts in the three months before and after a medication was prescribed.

Medications Associated with Increased Suicide Risk

The study identified ten medications that were statistically associated with a heightened risk of suicide attempts. Among these were the opioid painkiller hydrocodone bitartrate and acetaminophen (Vicodin), anti-anxiety medications such as alprazolam (Xanax) and diazepam (Valium), and the corticosteroid prednisone.

Medications Linked to Reduced Suicide Risk

Conversely, the researchers found forty-four drugs that appeared to decrease the risk of suicide. This group included several antidepressants, like fluoxetine and escitalopram (Lexapro), which also carry a “black box” warning. Additionally, the anticonvulsant gabapentin (Neurontin), used for seizure treatment, and certain medications for hypertension and Parkinson’s disease were associated with lower suicide attempts. Notably, the vitamin folic acid, commonly prescribed during pregnancy, was also linked to a reduction in suicide risk.

Future Implications of the Research

The researchers are optimistic that their new statistical model will enhance understanding of the relationship between medications and suicide, aiding in the selection of appropriate drugs for patients at higher risk. Robert Gibbons, PhD, Director of the Center for Health Statistics at the University of Chicago and lead author of the study, stated, “What we’ve done is come up with an alternative approach to drug safety surveillance that could be used by any agency, country, or formulary. We simultaneously did this analysis on all 922 drugs, and from that model, we can back out the risk for each one individually.”

References

Gibbons, R., Hur, K., Lavigne, J., Wang, J., and Mann, J. (2019). Medications and Suicide: High Dimensional Empirical Bayes Screening (iDEAS).
EurekAlert!. (2019). Study calculates links between prescription medications and risk for suicide. [online] Available at: https://www.eurekalert.org/pub_releases/2019-11/uoc-scl110519.php [Accessed 7 Nov. 2019].
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