Hypnotic Medications and Suicide: Risk, Mechanisms, Mitigation, and the FDA
| Autor: | Laryssa McCloud, Peter B. Rosenquist, W. Vaughn McCall, Doug Case, Andrew D. Krystal, Meredith E. Rumble, Mary Anne Riley, Ruth M. Benca, Jill C. Newman |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Suicide Prevention
Poison control Medical and Health Sciences Suicide prevention Occupational safety and health Cohort Studies 0302 clinical medicine Sleep Initiation and Maintenance Disorders Cause of Death Hypnotics and Sedatives Prospective Studies 030212 general & internal medicine Suicidal ideation Depression (differential diagnoses) Psychiatry Depression Middle Aged Product Surveillance Postmarketing Suicide Psychiatry and Mental health Mental Health Medical emergency Drug medicine.symptom Cohort study Risk Adult medicine.medical_specialty Suicidal Ideation Dose-Response Relationship 03 medical and health sciences Behavioral and Social Science Injury prevention medicine Humans Adverse effect Aged United States Food and Drug Administration business.industry Prevention Psychology and Cognitive Sciences medicine.disease United States Brain Disorders Sleep business Mind and Body 030217 neurology & neurosurgery |
| Zdroj: | The American journal of psychiatry, vol 174, iss 1 |
| ISSN: | 1535-7228 0002-953X |
| DOI: | 10.1176/appi.ajp.2016.16030336 |
| Popis: | ObjectiveInsomnia is associated with increased risk for suicide. The Food and Drug Administration (FDA) has mandated that warnings regarding suicide be included in the prescribing information for hypnotic medications. The authors conducted a review of the evidence for and against the claim that hypnotics increase the risk of suicide.MethodThis review focused on modern, FDA-approved hypnotics, beginning with the introduction of benzodiazepines, limiting its findings to adults. PubMed and Web of Science were searched, crossing the terms "suicide" and "suicidal" with each of the modern FDA-approved hypnotics. The FDA web site was searched for postmarketing safety reviews, and the FDA was contacted with requests to provide detailed case reports for hypnotic-related suicide deaths reported through its Adverse Event Reporting System.ResultsEpidemiological studies show that hypnotics are associated with an increased risk for suicide. However, none of these studies adequately controlled for depression or other psychiatric disorders that may be linked with insomnia. Suicide deaths have been reported from single-agent hypnotic overdoses. A separate concern is that benzodiazepine receptor agonist hypnotics can cause parasomnias, which in rare cases may lead to suicidal ideation or suicidal behavior in persons who were not known to be suicidal. On the other hand, ongoing research is testing whether treatment of insomnia may reduce suicidality in adults with depression.ConclusionsThe review findings indicate that hypnotic medications are associated with suicidal ideation. Future studies should be designed to assess whether increases in suicidality result from CNS impairments from a given hypnotic medication or whether such medication decreases suicidality because of improvements in insomnia. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|