A need for personalised suicidology: Pharmacoepidemiology

Abstract

A principal issue in pharmacoepidemiology is to estimate the impact of drugs on suicide risk in view of numerous methodological limitations. Owing to methodological concerns or differences, the findings of studies are often conflicting so it is difficult to draw conclusions about the suicide risk associated with drugs. An additional challenge in personalised suicidology is to identify characteristics of patients whose risk of suicide is increased when they are exposed to specific drugs. In this review, we investigate the impact of drugs on suicide risk in specific populations and the characteristics associated with an increased risk for the various therapeutic classes on the basis of the available data. Suicidal behaviours are linked to at least 58 different approved prescription drugs. The main mentioned classes are antidepressants, anticonvulsants and smoking cessation drugs. Antidepressants, anticonvulsants and sedative medications have been associated with suicidal behaviour in specific contexts. However, these associations remain to be proven and their mechanisms elucidated.