@article{ref1,
title="Pharmacological and somatic treatment effects on suicide in adults: a systematic review and meta-analysis",
journal="Depression and anxiety",
year="2021",
author="Wilkinson, Samuel T. and Trujillo Diaz, Daniel and Rupp, Zachary W. and Kidambi, Anubhav and Ramirez, Karina L. and Flores, José M. and Avila-Quintero, Victor J. and Rhee, T. Greg and Olfson, Mark and Bloch, Michael H.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Suicide is a public health crisis. We conducted a systematic review and meta-analysis of the effects of psychopharmacologic and somatic therapies on suicide risk. <br><br>METHODS: A systematic search of MEDLINE for studies evaluating the effects of pharmacologic (excluding antidepressants) or somatic interventions on suicide risk was conducted. Studies were included if they used a comparison group, reported on suicide death, assessed a psychopharmacological or somatic intervention, and included adults. Study quality was assessed using the Newcastle-Ottawa scale. Fifty-seven studies were included from 2940 reviewed citations. <br><br>RESULTS: In bipolar disorder, lithium was associated with a reduction in the odds of suicide compared to active controls (odds ratio [OR] = .58, p = .005; k = 12) and compared to placebo/no lithium (OR = .46, p = .009; k = 9). In mixed diagnostic samples, lithium was associated with a reduction in the odds of suicide compared to placebo/no lithium (OR = .27, p < .001; k = 12), but not compared to active controls (OR = .89, p = .468; k = 7). In psychotic disorders, clozapine was associated with a reduction in the odds of suicide (OR = .46, p = .007; k = 7). Associations between suicide death and electroconvulsive therapy (OR = .77, p = .053; k = 11), non-clozapine antipsychotics in bipolar disorder (OR = .73, p = .090; k = 6) and antipsychotics in psychotic disorders (OR = .39, p = .069; k = 6) were not significant. There was no consistent relationship between antiepileptic mood stabilizers and suicide. There were insufficient studies to meta-analyze associations of suicide risk with vagus nerve stimulation, transcranial magnetic stimulation, magnetic seizure therapy, or transcranial direct current stimulation. <br><br>CONCLUSION: Lithium and clozapine have consistent data supporting protective effects against suicide in certain clinical contexts.<p /> <p>Language: en</p>",
language="en",
issn="1091-4269",
doi="10.1002/da.23222",
url="http://dx.doi.org/10.1002/da.23222"
}