Suicide Risk Risk of Meds vs. Suicide Risk of Being Unmedicated - The Good, The Bad and The Funny. From People Who Have Taken These Crazy Meds...and SCIENCE!

Remember: Nobody on this site is a doctor, therapist, or a pharmacist. Know your sources! Crazy Meds is not responsible for the content of sites we provide links to. We like them, but what's on those sites is their business, not ours.

What You Need To Know About the Suicide Risk from Meds.

Please note that this article is still a work in progress. I still need to do a lot more research on it, and the drug companies are just now making the data available. I didn't have access to my computer or books for almost a month and I'm still catching up with unpacking, paying bills, selling my house and all that crap. But this is a huge issue that is on everyone's mind right now, so I had better deal with what I do know and get it out there.

Once I do get together hard numbers about specific meds, I'll include them here.

First off, all psychiatric / neurological medications carry a suicide risk. Antidepressants, antipsychotics, anticonvulsants (a.k.a. mood stabilizers), all of them. It's not just SSRIs. However, many of the illnesses have an inherently greater risk of suicide than you'd get from the meds.

But look at those odds and think about how ill you are now. Take into account the odds of your illness killing you.

Lifetime chance of death by suicide:

Bipolar Disorder   15.50%

Mixed Drug Abuse   14.70%

Major Depression   14.60%

Epilepsy¹      13.00%

Dysthymia      8.65%

OCD   8.15%

Panic/Anxiety   7.15%

Personality Disorders   5.05%

Alcoholism      4.20%

Cancer      1.30%

General Population       0.72%

From the article where I got the above statistics, Reducing suicide risk
in psychiatric disorders:

In a review of 22 studies—some including patients with bipolar or recurrent unipolar major depression—risk of death by suicide was reduced at least 5-fold, based on an informal comparison of pooled rates in treated versus untreated samples. Based on quantitative meta-analysis, the pooled risk of death by suicide was reduced nearly 9-fold (or by 89%) in patients who received lithium maintenance treatment compared with those who did not. The risk for suicide attempts fell nearly 10-fold in a compilation of 33 studies (Table 2).

For schizophrenia and other primary psychotic disorders, little research exists to indicate that atypical antipsychotics reduce suicide risk. Evidence is emerging, however, that clozapine may offer this benefit, in addition to its well-substantiated clinical superiority in treatment-resistant psychotic illness.

Another study associated olanzapine with a 2.3-fold lower risk of suicidal behavior, compared with haloperidol.

In Depressionland things aren't as cheerful.

antidepressants of various kinds may tend to reduce the risk of suicidal behavior, but any such effect is small and statistically nonsignificant (Baldessarini et al, 2003, unpublished)

tricyclic antidepressants may yield lower rates of suicidal behavior than selective serotonin reuptake inhibitors (SSRIs). Similarly, however, such trends reflect highly variable research methods and inconsistent findings and do not hold up to quantitative analysis (Baldessarini et al, 2003, unpublished).

Some of the above disorders kill in other ways. In addition to the higher suicide rate, epileptics in general have a higher mortality rate. Treating the seizures reduces the risk of death in all of its various forms. And, as it turns out, taking the meds DOES NOT increase the risk of SUDEP or status epilepticus after all. So we're a lot less likely to die if we just take our goddamn meds.

The complex calculus is: how much more likely are you to off yourself sooner by taking a med now than later by not taking anything at all?

I can't answer that question.

You alone can't answer that question.

It takes you, the people around you who have seen how your behavior has changed (whomever you like and trust in these matters, e.g. family, friends, coworkers), one good psychiatrist and at least one good therapist and preferably another counselor of some kind (e.g. a support group leader, a priest / minister / rabbi / spiritual advisor, a competent school counselor, you get the idea).

It doesn't matter what the problem is - major depressive disorder, bipolar disorder, epilepsy, schizophrenia, OCD, panic/anxiety, neuropathic pain - they all suck donkey dong and they can all potentially kill you.

If they are severe enough.

Let's be clear on a few points:

Not all things that make us mentally interesting are fatal.
Not everyone who is crazy needs drugs.
Certain disorders almost always need drugs. Face it, if you're bipolar and/or epileptic, meds are the first line of treatment. I tried going the non-med way and barely got out of it alive.

One of the many problems with the health care "system" in the US is everyone, the patients, doctors and insurers included, wants a quick fix.

But when it comes to the most complicated part of our bodies, the one thing that most defines who the hell we are, there is no quick fix.

Whether you need meds or not, if you're mentally interesting (a.k.a. crazy, mentally ill, sick in the head, loony, nuts, cuckoo, etc.) you will need the following no matter what:

Therapy
Coping tools and skills
A support group
A network of people to check in on you
Regular exercise
A good, healthy diet

Now some tips to help you decide if meds are worth the risk of suicide and other side effects.

It's really a very simple decision.

What sucks less, what you're suffering through now, or all the potential side effects?

If meds are strictly optional, then you can try everything else first.

Let's take depression as an example, because while I think while some people are avoiding meds who really need them, I really think that modern antidepressants are vastly over-prescribed in this country.

There are people taking them who don't need them at all.
There are people taking them at dosages that are inappropriately high.
And some folks are taking far too potent meds (e.g. Paxil (paroxetine) or Zoloft (sertraline)) when a milder med would do (e.g. Prozac (fluoxetine)

In the PI Sheets for all modern antidepressants it states that when used to treat depression, they are specifically for Major Depressive Disorder. But what is it really like to be depressed as fuck? Here's my take on it. Keep in mind that bipolar depression, with its mixed states, tends to be somewhat worse than vanilla, unipolar MDD, but mileage will always vary.

The thing is, you really have to be laying in bed, staring at the ceiling for days at a time in a world of endless pain for no good reason to be considering meds right off the bat.

Or if you have been laying in bed in a world of endless pain and have finally managed to overcome all the hurt and suffering to stumble across this shitty website - stop beating yourself up for nothing and realize that you do need meds! Your brain just doesn't work quite to spec and needs some fine tuning. You'll still need the therapy and everything else mentioned above, but you're not less of a person for needing a little chemical help. No more so than a diabetic who needs insulin.

And if all that endless pain is going to be the death of you anyway, what have you got to lose?

OK, next up, just why the hell people sometimes get more suicidal on these crazy meds and what you can do to lessen the risk.

Crazy Meds Home Crazy Meds Talk About Antidepressants About SSRIs About Anticonvulsants / Mood Stabilizers About Atypical Antipsychotics About Benzodiazepines About Stimulants Finding a Doctor Sites with More Information Support Group Sites About Crazy Meds Crazy Meds: The Blog

Take care, and keep taking your crazy meds!

If you still have unanswered questions about this or other medications, including which one is, or combination of meds are the best for you, your best bet is to ask on Crazy Meds Talk. Better yet, if you want to let the world know how they worked out for you and want to help out others in their quest for the correct meds, join the party.
If you want to discuss your issues, I suggest checking out one of the various support groups online.
Otherwise, if you're letting me know about how much you like or hate the site, or need to let me know about medication effects in private, then just drop a note to jerod23 at gmail dot com Honestly, I usually don't have a lot of time to answer e-mail these days. The snide autoresponse message that may or may not hit your mailbox is going to tell you the same thing.
Another problem is that you may not get a response even if I wanted to send you one. You see, so many dickweeds with malicious intents and too much time on their hands have appropriated the crazymeds.org domain name to use for their spam, viruses and the like. Subsequently some lazy-ass e-mail protection software authors just go by the domain name, and not the IP address. So I've been blacklisted because of the actions of others. Or the software just doesn't like the domain name because of the "crazy" and/or "meds." Or your question about a particular medication will set off spam flags. So the e-mail just wouldn't go through regardless. Sorry.

Hey, did you find this page all by itself through Google or some other search engine? Great! But to really appreciate the entire site, you need to start here.

Dead tree references:

End of books used for this article.

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¹ From Psychiatric Disorders Associated With Epilepsy

Hey, did you find this page all by itself through Google or some other search engine? Great! But to really appreciate the entire site, you need to start here.

Created Wednesday, September 29, 2004

Last updated Saturday, May 15, 2010

Almost all of the material on this site is copyright © 2002, 2003, 2004, 2005, 2006 and 2007 Jerod Poore. Except, of course, the PI sheets, those are the property of the drug companies who developed the drugs the sheets are about. And any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That's usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that's OK to just do. Go for it! Please. As long as you include this copyright notice and the following disclaimer, I'm cool with it.

All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won't necessarily happen to you. Nobody on this site is a doctor, therapist, or a pharmacist. We don't portray them either here or on TV. Only doctors can diagnose and treat an illness. Some doctors tend to get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don't be a cyberchondriac, thinking you have every disease you see a website about, or that you'll get every side effect from every medication. Self-prescribing is just as dangerous. All information on this site has been obtained through personal experience, the experiences of my friends, the experiences of people reported on online support groups, and from sources that are referenced throughout the site. Know your sources! As such the information presented here is not a substitute for real medical advice from your real doctor, just a compliment to it. No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. All brand names of the drugs listed in this site are the trademarks of the companies listed after them in the pages about the drugs, even though those companies may or may not have been acquired by other companies who may or may not be listed in this site by the time you read this. Always read the PI sheet that comes with your medications and never ever throw them away. If you didn't get a PI sheet, demand one. Loudly. Crazy Meds is not responsible for the content of sites we provide links to. We like them, or they're paid advertisements, or they're something you should read to make an informed decision about a particular med. Sometimes they're more than one of those things. But what's on those sites is their business, not ours. Very little information about visitors to this site is collected or saved. And from time to time I do look at search terms used to find it in an effort to make the information I present more relevant. Use only as directed. Void where prohibited.

"Everything is true, nothing is permitted." - Jerod Poore