Table 4

Characteristics of suicidality events

Study

Treatment

Event, study day(s)

Age, years

Gender

Adverse event term(s)

Relevant history


Completed suicide: 0


Suicide attempts: 4


Mania maintenance

DVPX

241

21

Female

Overdose, suicide attempt

Benzodiazepine overdose after a family conflict. Family history of bipolar disorder; history of previous SA.


Mania maintenance

DVPX

313

43

Female

Manic depressive reaction, overdose, suicide attempt

Benzodiazepine overdose. Family history of alcoholism, ADHD; previous SA approximately 12 months prior; SADS-C suicidal tendency score was 1 (not at all) on day 308.


Mania maintenance

Placebo

71

29

Female

Overdose

Benzodiazepine + alcohol combination 'due to poor judgment'. Marital break-up and lost custody of children. Family history of anxiety, depression.


Bipolar depressiona

Placebo

19

18

Male

Euphoria, abdominal pain, overdose

Amphetamine overdose. One SA in past year; mother died in past year; HAM-D rated as 0 (absent) and BPRS rated as 0 (not present) on day 15.


Preparatory acts toward imminent suicidal behavior: 1


Mania maintenance

Placebo

29

26

Female

Depression

Severe depression and suicidal ideation 1 day post treatment. Family history of mood, eating, and drug abuse disorders; history of borderline personality disorder; five SA since 1983 (last approximately 1 year prior); SADS-C rated as 1 (not at all) on day -1, 2 (slight) on day 7 and 5 (severe) on day 29.


Suicidal ideation: 15b


Epilepsy, adjunctive CPS

DVPX

19

21

Female

Depression

Severe thoughts of suicide that resolved the next day. History of drug abuse (approximately 1 year recovered), violent during seizures, and decreased mental sharpness; CBZ.


Acute mania

DVPX

2

33

Female

Depression

Moderate suicidal thoughts lasting 6 hours after a 'family event'. SADS-C rated as 0 (not at all) on day -1 and day 5.


Mania maintenance

DVPX

24

52

Male

Depression

Moderate suicidal ideation. Family history of suicide, abuse, electroconvulsive therapy, and residing in mental institution; history of obesity, diabetes, cardiovascular disease; SADS-C rated as 2 (slight) on day 15 and 4 (moderate) on day 30.


Mania maintenance

DVPX

23

31

Female

Depression

Severe depression, BDI indicated suicidal ideation. Family history of mood swings; SADS-C rated as 1 (not at all) on days -1 and 7, and 5 (severe) on day 24.


Mania maintenance

DVPX

196

22

Male

Depression

Severe depression and suicidal ideation. SADS-C rated as 3 (mild) on day 1.


Mania maintenance

DVPX

1

28

Male

Thinking abnormal thoughts

Moderate fleeting thoughts of wanting to hurt self (non-suicidal). SADS-C rated as 1 (not at all) on day -1, and 2 (slight) on day 18.


Mania maintenance

DVPX

44, 234

45

Male

Depression

Two episodes of suicidal ideation (severe and mild, respectively). Family history of depression; SADS-C rated as 6 (extreme) on day 55 and 3 on day 218; paroxetine.


Impulsive aggression

DVPX

16

37

Male

Depression

Severe hostility, depression and suicidal ideation, 'stress due to friend's death'. History of major depression, HIV positive (3 months), childhood physical abuse, possible PTSD; HAM-D rated as 1 (life not worth living) on day -22.


Impulsive aggression

DVPX

38

36

Female

Depression

Moderate feelings of worthlessness and hopelessness, mild thoughts of suicide. History of intermittent explosive disorder, alcohol dependence, cluster B personality disorder-borderline; HAM-D was rated as 0 (absent) on days 28 and 48.


Mania maintenance

Placebo

54

31

Male

Depression

Severe suicidal ideation and intent. Family history of depression; history of panic attacks; SADS-C rated as 3 (mild) on day 43 and 6 (extreme) on day 54; thyrosin, sertraline.


Mania maintenance

Placebo

188

45

Female

Manic depressive reaction

Severe suicidal ideation. Family history of bipolar disorder, depression; SADS-C rated as 1 (not at all) on day 175 and 5 (severe) on day 188.


Mania maintenance

Placebo

116

41

Female

Manic depressive reaction

Severe suicidal ideation and psychosis; SADS-C rated as 1 (not at all) on day 111 and 4 (moderate) on day 116.


Mania maintenance

Placebo

131

38

Male

Depression

Mild and transient suicidal ideation after ethanol consumption. Family history of bipolar disorder; SADS-C rated as 2 (slight) on day 115.


Mania maintenance

Placebo

39

32

Female

Psychotic depression

Severe depression and suicidal ideation. Family history of depression; SADS-C rated as 3 (mild) on day 28.


Impulsive aggression

Placebo

20

31

Female

Depression

Mild suicidal ideation with no plans/means that resolved within 2 hours. History of major depression, physical abuse, witnessed domestic violence, borderline cluster B personality disorder; HAM-D rated as 0 (absent) on day -15 and 28.


Epilepsy, monotherapy

Low-dose DVPX

17

33

Female

Depression

Moderate depression and thoughts of suicide. Marital and financial issues; history of anxiety, CBZ.


aThis subject also experienced an event of suicidal ideation (code 4) on day 17; only the most severe event is included in this table.

bN = 15 in placebo-controlled studies when counting the most severe event in patients experiencing >1 event.

ADHD = attention-deficit hyperactivity disorder; BDI = Beck Depression Inventory; BPRS = Brief Psychiatric Rating Scale suicidal thoughts; CBZ = carbamazepine; CPS = complex partial seizures; DVPX = divalproex sodium; HAM-D = Hamilton Depression Rating Scale suicide score; PTSD = post-traumatic-stress disorder; SA = suicide attempt; SADS-C = Schedule for Affective Disorders and Schizophrenia-Change Version suicidal tendency score.

Redden et al. Annals of General Psychiatry 2011 10:1   doi:10.1186/1744-859X-10-1

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