Suicide is listed as a side effect of over 200 common medications. How, specifically, do these medications increase the risk of suicide?

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I understand it if a person was already suicidal or depressed that certain medications could intensify those thoughts, but for someone who has pneumonia for example and is prescribed Prednisone ( a common steriod, one which lists depression, suicidal thoughts (and actions) as possible side effects, how would that cause an increase in suicidal thoughts?

In: Biology

A lot of the reason they put that warning label on is due to the medicine changing mood, not necessarily causing the risk of suicide. It’s mainly to cover their butts in case someone claims that the medicine caused someone to suicide.

A lot of the time they don’t.
Take Accutane, for instance. There is no evidence of any kind that it increases the risk of suicidal thoughts. But a kid on Accutane flew a plane into a building in ?Dallas in the late 90s, lawyers had a field day, and the drug companies wanted to cover their asses. As a result, I now have to waste time telling patients this story when they ask me why there’s a warning about suicide on their medication packaging.

TLDR: legal, not medical reasons in this case.

This is a common side effect listed on a lot of anti-depressants.

One theory as to why there seems to be an increase in suicidal thoughts is that in short the patient becomes so numb to depression they don’t realize how bad it is, when they start to feel better or sees other people happy it can jump start a desire to just end things.

To understand it helps to know that depression isn’t usually just “being sad” but for many patients a complete lack of feeling. They’ve been down for so long they repress all emotion and end up with just a flat baseline emotion of “not happy”, every day is the same and just rather “bleh” . They then take medication, which works and start feeling better. They start to feel “normal”, they have good days and bad days like everyone else on earth. However they are so accustomed to not feeling anything the sudden drop from a good day to a bad day seems far worse and can push them into self harm. The second piece is that the patient may have had plans or a desire to commit suicide or harm themselves for a long time, but due to the depression they have a complete lack of energy. They are so depressed they don’t do the things they would normally enjoy, hobbies or seeing friends or family, and ironically “don’t even see the point of carrying out plans to end their life. If the medication begins to work and they regain energy and motivation, but the circumstances of their life has not changed (or not changed in the way they desired) they may view it as a simpler solution.

It’s less explicit with medications that has a purpose other than treating depression, but many medications will still affect or alter mood and sleep patterns which can exacerbate the above even if the depression (or related mood/ suicidal thoughts) weren’t previously obvious.

I was told from my psychiatrist that all side effects have to reported during drug trials. That’s why some drugs have side effects lists that are miles long. Well if someone was depressed and began feeling suicidal during the trial this has to be reported even if the person has a history of suicidal ideation.

I used to do clinical medical testing for cash. Many of the side effects listed are the result of having a control group of people take the medication, then give a sometimes hourly report about how they’re feeling. You have to report everything, even unrelated or inane stuff (ie “feeling tired” even though y’know it’s just because you can’t have coffee during the study).

The environment is okay, but it’s still a lab setting and you’re required to stay indoors in a small tight area eating institutional food designed to not interfere with medications (so low fat, no spices, bland, low fat ect) for weeks to months at a time. So many of the potential “side effects” come from people listing common symptoms of feeling isolated, tired, and unhappy. (Incidentally, viagra was first designed as a heart medication. It wasn’t until the clinical trials that discovered it caused surpriseBoners)