A review published in The American Journal of Psychiatry has found that hypnotic medications are associated with suicidal ideation, but whether the agents themselves increase risk has yet to be determined. 

A team of researchers sought to review the evidence to support or counter the claim that hypnotic drugs raise the risk of suicide (the inclusion of warnings in the prescribing information regarding suicide with hypnotic drugs was mandated by the Food and Drug Administration). They searched various databases, FDA postmarketing safety reviews, and detailed case reports for hypnotic-related suicides through the FDA’s Adverse Event Reporting System. 

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The data showed hypnotic drugs were associated with a higher risk for suicide but none of the studies adequately controlled for depression or other psychiatric conditions that may be associated with insomnia. Suicide deaths due to single-agent hypnotic overdoses were also reported. The authors highlighted a concern with benzodiazepine receptor agonist hypnotics possibly causing parasomnias, which could lead to suicidal ideation or behavior in rare instances. There is also ongoing research on whether the treatment of insomnia can lower suicidality in adults with depression. 

Findings from the review showed hypnotic medications were associated with suicidal ideation. Further studies should evaluate whether increases in suicidality are due to central nervous system (CNS) impairments from a given hypnotic agent or whether hypnotic agents could decrease suicidality by improving insomnia.

For more information visit ajp.psychiatryonline.org.