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Revista chilena de neuro-psiquiatría

versión On-line ISSN 0717-9227

Resumen

MARTINEZ-AGUAYO, Juan Carlos et al. Antipsychotics and suicide. Rev. chil. neuro-psiquiatr. [online]. 2016, vol.54, n.2, pp.141-150. ISSN 0717-9227.  http://dx.doi.org/10.4067/S0717-92272016000200008.

The opinions about the relationship between antipsychotics and suicide are controversial due to differences on reported evidence about their specific action. One ofthe most discussed topics is the increase of depressive symptomatology and the impact of some secondary effects on suicidality, mainly akinesia, akathisia and tardive diskynesia. Another polemical topic is the paradoxical effect due to the decrease ofpositive symptoms when increasing insight. We performed a critical review of the available literature concerning to the use of antipsychotics in relation to suicide in the context of psychotic and affective disorders. When appraising psychotic disorders, there was no direct evidence to support a reduction in suicide rates when using first-generation antipsychotics, probably due to methodological issues and multifactoriality ofthe phenomenon. Nevertheless, second-generation antipsychotics could be protective against suicide risk, specifically clozapine, which is considered as an antisuicidal drug on schizophrenic disorders due to a direct antidepressant action and an indirect effect mediated by an improvement in cognitive functions. On the other hand, when appraising affective disorders, bipolar spectrum has demonstrated the greatest use of antipsychotics drugs, showing effectiveness in the management ofsuicide not greater than mood stabilizers. It becomes essential to identify the specific mechanism of action of antipsychotic drugs to assess their real effect on suicidality.

Palabras clave : Antipsychotic; suicide; clozapine; schizophrenia.

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