This post closes our series on akathisia. Along with posts on davidhealy.org, the other posts were:
In 500 drugs that cause depression and suicide, we mentioned building a new list of drugs that can cause depression and suicidality, and provided a draft version.
The list is now complete, and we’ve turned it into a new Guide about drugs that can cause depression, agitation and suicidality. The Guide gives the current list of drugs, which we expect to update at regular intervals. We would be grateful if you could share it as widely as possible.
Some of the Guide is reproduced below.
Life expectancy is falling or has stopped rising in Western and other developed countries. In some countries (USA) rising suicide rates have been highlighted as one possible factor in this fall.
In others (UK) the suicide rate doesn’t appear to be rising but it’s difficult to get a clear picture because unless people openly declare they are suiciding, coroners have been encouraged to return open verdicts, death by misadventure verdicts, or narrative verdicts.
Many people who have had a loved one made suicidal by a medication welcome verdicts like these as recognizing to some extent it was an external factor that caused the death rather than their child’s, parent’s or partner’s intention to take their own lives. The upshot however is we have no idea what the true rate of medication-induced suicide is. It is almost certainly rising in countries other than the United States as well.
Prescription medicines from antibiotics to contraceptives can increase your risk of suicide by triggering:
We have compiled a list of over 350 individual medicines that cause problems. Most of these drugs are marketed under many different trade names, sometimes hundreds of different trade names when language variations are taken into account. Many are marketed in combination with other medicines – sometimes with 3 or 4 or more medicines bundled into the same pill – with the result that you may not realize what drugs you are taking. The labeling of these drugs can differ across countries, with some labels revealing the risks in the very small print, and labels from other countries not revealing the risks from the same drug.
In total there are 40,000 or more different trade named drugs in North America and Europe that can make you depressed, agitated or suicidal. Roughly 20% of the named drugs on the market in any one country may pose risks to you. Roughly 33% of us are taking one of them.
The risk comes from the drug, not you. The difficulty in seeing this comes from the fact that we are all different. A drug that makes one person feel better, slows their heart rate or lowers their cholesterol, may make their friend suicidal, increase their heart rate or increase cholesterol levels. Companies trade on this – they sell the average headline effect of their drug as its only effect. If something else happens to you that’s an anecdote, or suggests you have another disease or even that you’ve fabricated things.
Astonishingly, companies get away with this. Even though the depression, anxiety, or suicidality that you are experiencing is written into the label of the drug you are on, your doctor may completely deny that this is a possibility when it seems obvious to you. Or just as bad, s/he may never point out to you that the symptoms you are having that you don’t connect to the drug, may in fact stem from this source. S/he will instead likely add in more drugs which will almost certainly make the problem worse.
As a recent article in JAMA showed, the more drugs you are on, the greater the risk you run. Taking three or more drugs that can cause a problem triples your risk of being dysphoric, akathisic, or suicidal.
Over 50% of us of all ages are on at least one drug and 50% over 45 are on at least three drugs, and 40% of over 65s are on five drugs or more.
There are variations in the risks these drugs pose. Being on a cocktail of drugs that includes a proton pump inhibitor (PPI) for acid reflux dramatically increases your risks, as do some anti-infectives like Lariam or fluoroquinolone antibiotics, whereas while statins are highly likely to cause fatigue they are less likely to cause suidicality or homicidality.
It is increasingly common for anyone taking a psychotropic drug, especially in America, to be on three or more psychotropics. If you are on three or more psychotropics, it is more likely than not that a significant part of your nervous problems stem from your medication.
The worry with psychotropic drugs is that by the time you read this, you may be close to or past the point of no return – getting back to a point where your medication is not causing your problem may be difficult.
Read the full list of drugs and what do if this happens to you or someone you know at: Drugs That Can Cause Depression, Agitation & Suicidality