Antipsychotics

Abstract

Suicide is a fatal outcome that frequently occurs in people suffering from schizophrenia and other psychoses. Lifetime rate of suicide in patients with schizophrenia has been reported to be around 10 %. Suicidal risk in schizophrenia is mainly related to affective symptoms, previous suicidal attempts, number of psychiatric admissions, younger age at onset, substance misuse or dependence, closeness to illness onset, male sex, and period during or following psychiatric discharge. Except for clozapine, no antipsychotic treatment has been established to be useful in reducing suicidality in patients with schizophrenia, being the only drug whose potential anti-suicidal properties have been officially recognized by the FDA in the USA. However, in light of recent data, the antisuicidal effect of antipsychotics could be extended to other second-generation antipsychotics (mainly olanzapine and risperidone). The anti-suicidal effect of antipsychotics in non-psychotic patients needs to be further demonstrated. Timely and appropriate use of antipsychotic agents, bearing in mind adverse events, might contribute to a net positive effect on suicidality in psychotic and perhaps even in non- psychotic patients.