Psychopharmacological therapy and suicide of inpatients with depressive psychoses

Abstract

Data on the psychopharmacological treatment of 3792 inpatients with mono- or bipolar depression during a twelve-year period were routinely documented in a systematic way by means of an electronic data processing system. Thirty-three of these patients committed suicide while in hospital; the remaining patients were used as controls (n = 3759). To identify possible differences in the pharmacological treatment of suicides and controls the data were classified according to the following drugs and drug groups: antidepressants, neuroleptics, tranquilizers, hypnotics, lithium, biperiden, beta-adrenergic blocking drugs, placebos and others. A comparison was made of how frequently the drugs were prescribed and of the mean number of prescriptions of neuroleptics, tranquilizers and antidepressants; the latter were in addition differentiated in sedating and non-sedating drugs. Moreover the mean daily dose of frequently used substances was compared. Whereas no significant difference for the groups was found with respect to the percentage of patients undergoing neuroleptic treatment, the mean number of prescriptions of neuroleptics was significantly higher at 1.3 per patient for the suicides than for the controls at 0.8 per patient. Furthermore a tendency towards a lower frequency of the prescription of lithium together with a lower mean dosage emerged for the suicides. No other hints of differences in the psychopharmacological treatment of suicides were found.

Key Words:

• affective psychoses
• depression
• psychopharmacology
• major affective disorder
• suicide
• suicidal behavior