Mental health articles

Medications for Depressive Disorders Of all the medications for the treatment of psychiatric disorders and dysfunctions related to suicidality, I will focus solely on antidepressants, because studies consistently fi nd that affective disorders are the most common diagnoses related to suicide. There are well over 20 antidepressants currently available, only a few of which are selective serotonin reuptake inhibitors (SSRIs). Some studies suggest that the use of antidepressants has lowered suicide rates in clinical populations (Isacsson, Holmgren, Druid, & Bergman, 1997), although these studies need to be prospectively replicated and carefully controlled. Global statements about causal mechanisms cannot be made, because truly rigorous studies have not been undertaken that compare and contrast all the available medications with specifi c target symptoms. Meanwhile, currently there is controversy as to whether certain classes of antidepressants can be associated with the worsening, or even the emergence, of suicidal ideation or behavior in the early weeks of treatment, particularly in children and adolescents (Mann & Kapur, 1991). However, there are reasons to believe that SSRIs might reduce suicidality and suicidal ideation because of their potential to reduce irritability, affective response to stress, hypersensitivity, depression, and anxiety (Isacsson et al., 1997; Leon et al., 1999). SSRIs remain the preferred psychopharmacological treatment for young adult depression, with the caution that suicidal patients on SSRIs must be watched for any increase in agitation or suicidality, especially in the early phase of treatment (Montgomery, 1997).

When medications are prescribed to suicidal individuals, careful monitoring
of dosage levels is essential. It’s important to prevent patients from
hoarding pills or having inappropriate access to them. While medications
may be essential in stabilizing and treating the suicidal young adult, all
administration must be carefully monitored for any unexpected change of
mood, increase in agitation or emergency state, or unwanted side effects, so
that dosages can be regulated (American Psychiatric Association, 2003; Shaffer
& Pfeffer, 2001).
When the primary therapist works with a prescribing physician, it is essential
that interactive lines of communication remain open. The nonmedical
therapist should be familiar with the common dosages, properties, therapeutic
effects, and side effects of prescribed medications. Moreover, the therapist
should inquire about, and report to the psychopharmacologist, signifi cant
changes in the patient’s behavior, signifi cant events threatening the behavioral
response, and any observed responses to medication (lack of compliance,
side effects, etc.).

Tags: depressive disorder, disorder