Pharmacological Strategies for Preventing Suicidal Behaviour

The assessment and management of suicidal patients are important issues that may be faced by any physician. A series of risk factors for suicide has been identified, which includes psychiatric diagnosis, psychosocial and environmental factors, personality disorders and traits, genetic and family variables, and biochemical factors. Knowledge of these risk factors can assist clinicians in determining those patients who are most likely to attempt to harm themselves. This in tum enables pharmacological intervention to prevent suicide attempts. Psychopharmacological agents such as antidepressants, anti psychotics (in patients with personality disorders) and lithium (in patients with bipolar disorders) have been shown to be effective in preventing suicidal behaviour. The efficacy of electroconvulsive therapy (ECT) is more controversial. Other equally important aspects of the optimal clinical management of suicidal patients are the quality of the doctor-patient relationship and the issues involved in deciding whether hospital admission of the patient is necessary.