TY - JOUR
T1 - Bipolar pharmacotherapy and suicidal behavior. Part 3
T2 - Impact of antipsychotics
AU - Yerevanian, Boghos I.
AU - Koek, Ralph J.
AU - Mintz, Jim
N1 - Funding Information:
The study was partially funded by Abbott Laboratories. Abbott laboratories provided funding for a research assistant. The funding source had no role in the design of the study; nor in the collection, analysis and interpretation of data, writing of the report; and in the decision to submit the paper for publication.
PY - 2007/11
Y1 - 2007/11
N2 - Introduction: Antipsychotics, particularly second generation agents, are widely used in bipolar disorder, but their effect on suicidal behavior in this population has not been systematically studied. Methods: Retrospective chart review of 405 veterans with bipolar disorder followed for a mean of three years, with month-by-month systematic assessment of current pharmacotherapy and suicide completion, attempt or hospitalization for suicidality. Comparison of rates of suicidal events during mood stabilizer monotherapy, antipsychotic monotherapy, and combination of mood stabilizer and antipsychotic. Results: Non-lethal suicide event rates were 9.4 times greater (χ2 = 28.29, p < .0001) during antipsychotic monotherapy and 3.5 times greater during mood stabilizer + antipsychotic (χ2 = 15.13, p = 0.0001) than during mood stabilizer monotherapy. Limitations: Antipsychotics may have been prescribed because patients were at greater risk of suicidal behavior. First and second generation antipsychotics were not distinguished. Conclusions: Treatment of bipolar patients with antipsychotics is associated with an increase in non-lethal suicidal behavior. Thus, use of antipsychotics for bipolar patients requires careful monitoring for suicidal behavior. Further studies are urgently needed to better characterize this relationship.
AB - Introduction: Antipsychotics, particularly second generation agents, are widely used in bipolar disorder, but their effect on suicidal behavior in this population has not been systematically studied. Methods: Retrospective chart review of 405 veterans with bipolar disorder followed for a mean of three years, with month-by-month systematic assessment of current pharmacotherapy and suicide completion, attempt or hospitalization for suicidality. Comparison of rates of suicidal events during mood stabilizer monotherapy, antipsychotic monotherapy, and combination of mood stabilizer and antipsychotic. Results: Non-lethal suicide event rates were 9.4 times greater (χ2 = 28.29, p < .0001) during antipsychotic monotherapy and 3.5 times greater during mood stabilizer + antipsychotic (χ2 = 15.13, p = 0.0001) than during mood stabilizer monotherapy. Limitations: Antipsychotics may have been prescribed because patients were at greater risk of suicidal behavior. First and second generation antipsychotics were not distinguished. Conclusions: Treatment of bipolar patients with antipsychotics is associated with an increase in non-lethal suicidal behavior. Thus, use of antipsychotics for bipolar patients requires careful monitoring for suicidal behavior. Further studies are urgently needed to better characterize this relationship.
KW - Antipsychotic drugs
KW - Bipolar disorder
KW - Longitudinal study
KW - Public health
KW - Suicide
KW - Suicide attempt
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U2 - 10.1016/j.jad.2007.05.018
DO - 10.1016/j.jad.2007.05.018
M3 - Article
C2 - 17604119
AN - SCOPUS:34548852844
VL - 103
SP - 23
EP - 28
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
IS - 1-3
ER -