Suicidal ideation

Depression occurring as part of bipolar disorder may be severe and accompanied by ideas of guilt and hopelessness, an inability to function at work because of poor concentration and psychomotor retardation or agitation, poor judgement and suicidal ideation. The lifelong risk of suicide in people with this condition is as high as 15%. Factors associated with suicide risk include alcohol misuse, marital separation or divorce, living alone and unemployment, and these are all common secondary consequences of the illness. 

Psychiatric adverse effects occur frequently and may include irritability, depression, and rarely, suicidal ideation. Individuals with a history of uncontrolled psychiatric disorders must weigh the risk versus benefit of treatment, as interferon may exacerbate or worsen the psychiatric condition. Patients who develop mild to moderate symptoms may require antidepressants or anxiolytics. Those with severe symptoms including suicidal ideation should have the treatment discontinued immediately.43... 

Recurrent thoughts of death, suicidal ideation, or suicide attempt... 

Suicidal ideation or attempts (suicide completion rates with bipolar I disorder are 10-15% suicide attempts are primarily associated with depressive episodes, mixed episodes with severe depression or presence of psychosis)... 

Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide... 

D. The symptoms are not better accounted for by bereavement (i.e., after the loss of a loved one), the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation. 

Patients should be monitored for emergence of suicidal ideation after initiation of any antidepressant, especially in the first few weeks of treatment. 

Implications of the prototypic classification method are that categories within the system will possess fuzzy boundaries. Individuals within a category will be somewhat heterogeneous and may not share any common features. In our depression example, a prototypic classification scheme may yield a diagnosis of depression in one patient who shows agitation, anhedonia, and suicidal ideation and the same diagnosis in another patient who shows sadness, fatigue, worthlessness, and decreased appetite. 

Psychoactive. Substances that have mood- or reality-altering properties. Referral. A process of sending your client to another professional for care. Schizophrenia. A debilitating class of mental disorders that involve psychosis. Suicidal ideations. Thoughts about self-harm or suicide. 

Clients with suicidal ideations should always be referred elsewhere. True or False ... 

Third, the center determines during the screening process whether the client is a threat to self or others. Suicidal behavior should be routinely assessed in a screening interview. Some care facilities do not have the resources to treat an actively suicidal client, so if the person expresses suicidal ideations and plans, then a referral may be made elsewhere. The treatment center also wants to protect clients and staff from someone who is extremely aggressive and hostile and may represent a threat to the safety of people in the unit. In some cases, treatment facilities may refer such people elsewhere if the threat cannot be adequately contained within that facility. 

There are data to confirm and reject the association of the Cys23Ser S-HT and the Gly22Ser 5-HTj receptor variants, characterized in vitro by reduced agonist potency, with phenotypes such as intractable suicidal ideation (98), ADHD (100), alcohol dependence, and schizophrenia (98,99,109-116). While the -1348 A/G polymorphism of the S-HT receptor has been associated with the negative symptoms of schizophrenia, other studies of eating disorders appear to be equivocal. A body of evidence is available, however, that S-HT variants may be associated with psychotic symptoms in Alzheimer s patients (94,100,117,118). 

The diagnosis of mania is made on the basis of clinical history plus a mental state examination. Key features of mania include elevated, expansive or irritable mood accompanied by hyperactivity, pressure of speech, flight of ideas, grandiosity, hyposomnia and distractibility. Such episodes may alternate with severe depression, hence the term "bipolar illness", which is clinically similar to that seen in patients with "unipolar depression". In such cases, the mood can range from sadness to profound melancholia with feelings of guilt, anxiety, apprehension and suicidal ideation accompanied by anhedonia (lack of interest in work, food, sex, etc.). 

Aripiprazole is an atypical antipsychotic agent that is not associated with an impact on prolactin levels and is not associated with impotence as a side-effect. It may precipitate suicidal ideation as a side-effect. 

Many propoxyphene-related deaths have occurred in patients with histories of emotional disturbances, suicidal ideation or attempts, or misuse of tranquilizers, alcohol, and other CNS-active drugs. Deaths have occurred as a consequence of the accidental ingestion of excessive quantities of propoxyphene alone or in combination with other drugs. Do not exceed the recommended dosage. 

Mania/Hypomania Use carefully in patients with a history of mania/hypomania. Suicidal ideation Closely supervise high-risk patients during initial drug therapy. Elective surgery Prior to elective surgery, discontinue maprotiline for as long as possible, because little is known about the interaction between maprotiline and general anesthetics. 

Suicide risk Patients with major depressive disorder, both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality), whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. 

Suicidal ideation Suicidal ideation may be a manifestation of certain psychiatric disorders and may persist until significant remission of symptoms occurs. 

Suicide In controlled clinical trials of acamprosate, adverse events of a suicidal nature (eg, suicidal ideation, suicide attempts, completed suicides) were more common in acamprosate-treated patients than in patients treated with placebo (1.4% vs 0.5%... 

Capsules/Tablets/Oral solution-There are significant adverse events caused by ribavirin capsules/interferon alfa-2b or peginterferon alfa-2b therapy, and ribavirin tablets/peginterferon alfa-2a therapy, including severe depression and suicidal ideation, hemolytic anemia, suppression of bone marrow function, autoimmune and infectious disorders, pulmonary dysfunction, pancreatitis, and diabetes. 

Suicidal Ideation (capsules/oral solution) Severe psychiatric adverse events including depression, psychoses, aggressive behavior, hallucinations, violent behavior (suicidal ideation, suicidal attempts, suicides) and rare instances of homicidal ideation have occurred during combination ribavirin capsulesZ/nfron A therapy, both in patients with and without a previous psychiatric disorder. 

Capsules/Oral solution - Suicidal ideation or attempts occurred more frequently among pediatric patients, primarily adolescents, compared with adult patients during treatment and off-therapy follow-up. Safety and efficacy of ribavirin in combination with peginterferon alfa-2b has not been established in pediatric patients. 

Depression Use interferon beta with caution in patients with depression or other mood disorders, conditions that are common with MS. Depression and suicide have been reported in patients receiving interferon compounds. Advise patients treated with interferon beta to immediately report any symptoms of depression or suicidal ideation. 

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