What Drugs Have the Highest Risk of Causing Suicidal Thoughts?

The American Foundation for Suicide Prevention (AFSP) reports that suicide is the 12th leading cause of death in the United States and that an estimated 1.2 million suicide attempts took place in 2020 alone. Our society must deal with this problem, but we have to know where to look. While many contributing factors are associated with attempted suicide or suicidal thoughts, one that deserves special consideration is drug use. Here’s what drugs have the highest risk of causing suicidal thoughts.

Who Are the Culprits?

Deciding which drugs have the highest risk of suicidal thoughts is tricky. This is because many illicit drugs affect the central nervous system (CNS), which is how the brain communicates with the rest of the body. CNS depressants work by slowing down or suppressing this messaging process. CNS depressants include benzodiazepines, opioids, sedative drugs, and even alcohol. Other drugs known as CNS stimulants work in the opposite way to CNS depressants by increasing central nervous system activity in the brain and the body. Stimulants include cocaine, crack, ecstasy, methamphetamine, and prescription stimulants, such as Adderall and Ritalin. Next to these, there’s marijuana, which is sort of a wild card drug because it can produce stimulant and depressant effects.

While it might sound like we’ve gone down the list of all available drugs rather than a list of drugs that cause suicidal thoughts, the reality is all these drugs, and many others, can lead to suicidal thoughts. Each of these drugs manipulates the central nervous system. As a result, they can influence our emotions, our cognitive decision-making, and our awareness. Additionally, underlying factors or mental health conditions can increase the possibility of experiencing suicidal thoughts from drug use.

Concerning Findings

With that said, it’s still true that certain drugs carry a higher potential for suicidal thoughts. While it is an oversimplification to associate stimulants or “uppers” with happiness and depressants or “downers” with sadness, the reality is that even uppers can cause severe depression, which can lead to suicidal thoughts. However, statistics show that most suicidal thoughts or acts are more commonly linked with depressants use. For example, a 2020 study revealed that suicidal drug overdoses ranked highest when people used opioids or barbiturates. Following those drugs, the third-ranking included antidepressant drugs. It is ironic that the medications that seem to carry a high risk for suicide and/or severe depression are, in fact, antidepressants. While benzodiazepines can treat anxiety-related depression, most instances of depression are treated with antidepressant medications, generally belonging to either the selective serotonin reuptake inhibitors (SSRIs) or the serotonin and norepinephrine reuptake inhibitors (SNRIs) class, though there are other less commonly used antidepressants as well.

Brand names that belong to these classes include drugs such as Cymbalta, Celexa, Prozac, and Zoloft. These drugs are more effective in treating depression than other options because they work in very specific ways to regulate serotonin in the body, which results in a stabilized mood. According to a study examining the link between SSRIs and suicidal thoughts, there is no clear connection between the two for adults. However, there was a higher risk of suicidal thoughts for children and adolescents. Researchers recommended that clinicians closely monitor and follow up with patients who use the medications they prescribed. In fact, this is exactly what we see in advertisements for antidepressant medications. The ads state the risk of the potential for depression and suicidal thoughts, followed by a warning to contact a doctor right away if these symptoms occur.

What to Do

Part of the controversy centered around the safety of antidepressant use concerns whether suicidal thoughts are pre-existing conditions of antidepressant drug use or if they are actually caused by taking the drugs. Additionally, mixing antidepressants with other drugs can create risks that can be detrimental to mental health. This information should not deter anyone from getting medical treatment for suicidal thoughts or depression-related symptoms. However, we can use it to educate ourselves about just how complex the problem is and what drugs to pay close attention to as we maintain our mental health and the mental health of others around us.

Sources

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Delphi Health Group. (n.d). Guide to Drug Addiction: Symptoms, Signs, and Treatment. Retrieved https://delphihealthgroup.com/addiction/

Medical News Today. (2018 Oct 9). What is Central Nervous System (CNS) Depression? Retrieved https://www.medicalnewstoday.com/articles/314790

Delphi Health Group. (n.d.). Guide to Alcohol Detox: Severity, Dangers, and Timeline. Retrieved https://delphihealthgroup.com/alcohol/detox/

Delphi Health Group. (n.d.). Stimulant Addiction. Retrieved https://delphihealthgroup.com/stimulants/

Healthline. (2019 May 6). Is Weed a Depressant, Stimulant, or Hallucinogen? Retrieved https://www.healthline.com/health/is-weed-a-depressant

Vox. (2018 Jun 15). Depression and Suicide Risk are Side Effects of more Than 200 Common Drugs. Retrieved https://www.vox.com/science-and-health/2018/6/14/17458726/depression-drugs-suicide-side-effect

Delphi Health Group. (n.d.). A Guide to Dual-Diagnosis Treatment. Retrieved https://delphihealthgroup.com/treatment-guide/dual-diagnosis/

Delphi Health Group. (n.d.). Guide to Cocaine Addiction and Treatment. Retrieved https://delphihealthgroup.com/stimulants/cocaine/

JAMA. (2020 Mar 23). Incidence and Lethality of Suicidal Overdoses by Drug Class. Retrieved https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763226

NIH. (2010 Sep 3). Antidepressants and Suicide Risk: A Comprehensive Overview. Retrieved https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034101/

Delphi Health Group. (n.d.) Mixing Alcohol and Antidepressants – Can You Do It Safely? Retrieved https://delphihealthgroup.com/alcohol/and-antidepressants/

NIH. (2012 Jan). Suicide and Antidepressants: What Current Evidence Indicates. Retrieved https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3353604/

Medical News Today. (2017 Dec 14). What is Prozac (fluoxetine)? Retrieved https://www.medicalnewstoday.com/articles/263773

NHS. (2021 Dec 8). Cautions- Selective Serotonin Reuptake Inhibitors (SSRIs). Retrieved https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/considerations/#:~:text=Interactions%20with%20other%20medicines,known%20as%20%22serotonin%20syndrome%22.

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