Managing suicide risk in patients with schizophrenia.

  • Tiihonen J
  • Lönnqvist J
  • Wahlbeck K
 et al. 
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The management of suicide risk in patients with schizophrenia poses many challenges for clinicians. Compared with the general population, these patients have an 8.5-fold greater risk of suicide. This article reviews the literature dealing with the treatment of at-risk patients with schizophrenia. An integrated psychosocial and pharmacological approach to managing this population of patients is recommended. Although there is at least modest evidence suggesting that antipsychotic medications protect against suicidal risk, the evidence appears to be most favourable for second-generation antipsychotics, particularly clozapine, which is the only medication approved by the US FDA for preventing suicide in patients with schizophrenia. In addition, treating depressive symptoms in patients with schizophrenia is an important component of suicide risk reduction. While selective serotonin receptor inhibitors (SSRIs) ameliorate depressive symptoms in patients with schizophrenia, they also appear to attenuate suicidal thoughts. Further research is needed to more effectively personalize the treatment of suicidal thoughts and behaviours and the prevention of suicide in patients with schizophrenia.

Author-supplied keywords

  • Antidepressant
  • Antipsychotic
  • Antipsychotic Agents
  • Antipsychotic Agents: therapeutic use
  • Antipsychotics
  • Clozapine
  • Humans
  • Medication
  • Meta-analysis
  • Mortality
  • Psychopharmacology
  • Response
  • Schizophrenia
  • Schizophrenia: complications
  • Schizophrenia: drug therapy
  • Schizophrenia: therapy
  • Serotonin Uptake Inhibitors
  • Serotonin Uptake Inhibitors: therapeutic use
  • Social Support
  • Suicidal behavior
  • Suicide
  • Suicide: prevention & control
  • Suicide: psychology
  • Suicide: statistics & numerical data
  • accepted 12 december 2013
  • antipsychotics
  • epidemiology
  • mortality
  • pharmacoepidemiology
  • re-hospitalisation
  • received 19 august 2013
  • revised 20 november 2013
  • suicide
  • suicide attempts

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  • Jari Tiihonen

  • Jouko Lönnqvist

  • Kristian Wahlbeck

  • Timo Klaukka

  • Leo Niskanen

  • Antti Tanskanen

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