J Korean Med Sci.  2024 Aug;39(31):e226. 10.3346/jkms.2024.39.e226.

Psychotropic Medications Promote Time-Dependent Reduction of Suicidal Ideation in Mood Disorder: A Prospective Cohort Study

• Yang JH
• Park CHK
• Rhee SJ
• Kang DH
• Kim MJ
• Lee HJ
• Lee SY
• Shim SH
• Moon JJ
• Cho SJ
• Kim SG
• Kim MH
• Lee J
• Kang WS
• Yoo J
• Lee WY
• Ahn YM

• KMID: 2558525
• DOI: http://doi.org/10.3346/jkms.2024.39.e226

Abstract

Background
Despite a plethora of research on the topic, there is still no solid evidence that pharmacological treatment actually reduces the risk of suicide in patients with mental illness. In this study, we aimed to assess the effect of psychotropic medications on suicidal ideation in patients with major depressive disorder (MDD) and bipolar disorder (BPD) in two age groups: less than 25 years and 25 years and older.
Methods
We analyzed 312 patients with mood disorders with current suicidal thoughts or recent suicide attempts. We followed the participants from baseline for 6 months and assessed changes in suicidal ideation with Columbia-Suicide Severity Rating Scale (C-SSRS). The effect of psychotropic drug administration on suicidal ideation over time was analyzed using a linear mixed model.
Results
In patients aged 25 years and older with mood disorders, suicidal ideation was more severe when using psychotropic drugs than when not using them. However, suicidal ideation decreased rapidly over time. The time-dependent reduction in suicidal ideation was accelerated when using antidepressants and sedatives/hypnotics in adult MDD, and when using mood stabilizers in adult BPD. However, this effect was not observed in participants aged less than 25 years.
Conclusion
Adequate psychotropic medication may reduce suicidal ideation in patients with mood disorders aged 25 years and older. Additional research on psychotropic drugs is needed to effectively reduce the risk of suicide among children and adolescents with mood disorders.

Keyword

Suicide; Suicidal Ideation; Psychotropics; Psychiatric Treatment; Antidepressant

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