Several prescription drugs have been associated with an increased risk of suicidal thoughts, behaviors, and in some cases, homicidal tendencies. The number of drugs that carry these risks is difficult to pinpoint precisely, as it can vary depending on factors like dosage, individual susceptibility, and other medical conditions. However, here’s an overview:
1. Drugs Associated with an Increased Risk of Suicide
- Antidepressants: Especially selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). These are known to carry “black box” warnings for increased risk of suicidal thoughts and behaviors, particularly in children, adolescents, and young adults.
- Antipsychotics: Some antipsychotic medications used for schizophrenia, bipolar disorder, and severe depression have been linked to suicidal ideation.
- Anti-seizure Medications: Certain anticonvulsants, like topiramate and gabapentin, used for epilepsy, migraine prevention, and mood stabilization, have been associated with increased suicidal thoughts and behavior.
- Sleep Medications: Some sleep aids, including hypnotics like zolpidem (Ambien), can cause unusual behavior and mood changes, occasionally contributing to suicidal thoughts.
- ADHD Medications: Stimulants and non-stimulant medications for ADHD, such as atomoxetine (Strattera), have occasionally been linked to increased suicidal ideation, especially in young users.
- Steroids: Corticosteroids, when used for inflammatory conditions, can lead to mood swings, aggression, depression, and occasionally suicidal thoughts, especially at high doses.
2. Drugs Linked to Aggression and Homicidal Behavior
- Certain Antidepressants and Antipsychotics: Although rare, some individuals may experience agitation, aggression, or violent behavior when taking certain antidepressants and antipsychotic medications.
- Benzodiazepines: Used to treat anxiety and sleep disorders, benzodiazepines can sometimes cause disinhibition, leading to aggression or impulsive behavior.
- Corticosteroids: High doses of corticosteroids can induce psychiatric symptoms like mania, psychosis, and aggression, which could theoretically lead to violent behavior.
- Stimulants for ADHD: Stimulants like amphetamine-based medications have been occasionally associated with aggression or hostile behavior in some users.
- Chantix (Varenicline): This smoking cessation drug has been reported to cause aggressive or violent behavior, though this is relatively rare.
Regulatory and Research Insights
Regulatory agencies, such as the U.S. Food and Drug Administration (FDA), often issue “black box” warnings for medications with significant risks of suicidality, particularly for younger populations. Research into the links between specific medications and violent behavior is ongoing, but findings are often complex due to individual variability in reactions to medication, underlying conditions, and other medications taken concurrently.
Total Number of Drugs
A review published by the Institute for Safe Medication Practices in 2010 highlighted 31 prescription drugs most associated with reports of violence, including suicide and homicide risks. However, this list has likely grown as new medications and more recent reports come to light. Additionally, most medications with warnings for increased suicide risk are listed in drug databases or have alerts from the FDA or EMA (European Medicines Agency).