Warnings of Suicide and Homicidal thought, anger agitation aggression irritability from prescription Medication, Antidepressants anti-anxiety anti-psychotics ADHA. physicians who prescribe CNS active medications have a duty toward, my opinion as a practicing physician and former pharmaceutical industry researcher, Donald H Marks

Warnings of Suicide and Homicidal thought, anger agitation aggression  irritability as an adverse effect of prescription Medication such as Antidepressants, Anti-anxiety anti-depressants, ADHD and others 

by Donald H. Marks

Physician, scientist and 3rd generation veteran

The following is taken from the discussion section of my publications on the subject of medication-induced psychological adverse effects.. The general question I address is whether prescription medications, for medical or psychiatric problems, can actually make an individual's psychiatric situation unstable.

New or worsening (psychiatric) symptoms can represent adverse effects of prescribed medications, rather than a progression of the underlying disease state. Patients and their families should be informed and warned, as I have urged (cited ref below).

The treating/prescribing physician of medications that Can cause CNS adverse events should perform an adequate medical and psychiatric history and evaluation to ascertain the risk for using these medications in each patient. Professional help should be sought from psychiatrists with a good knowledge of psychopharmacology and substance-induced mood disorder (SIMD). Consideration should be given to the consequences in each patient of inducing increased anxiety, aggression, agitation, anger, depression, hallucinations, impulsivity, irritability, paranoia, or suicidal or homicidal ideation.  IMO all patients who receive psych drugs, and their immediate family and caregivers, must receive specific warning about potential induction of CNS adverse events, including: anxiety, aggression, agitation, anger, depression, hallucinations, impulsivity, irritability, paranoia, suicidal or homicidal ideation. (Marks et al 2008)

Patients receiving CNS-active medications should be queried at regular intervals for the development of CNS adverse events, and appropriate follow-up should be performed. If a person receiving these medications develops new or heightened suicidal or homicidal thoughts, it is important for the treating/prescribing physician to determine whether the medication should be discontinued. Patients developing CNS adverse events should be questioned concerning their degree of risk to themselves and others, and they should be requested to notify anyone who may be at risk from their actions. Professional psychiatric input should be considered. All these actions should be documented in the medical records.

References

1. Marks DH, Breggin PR. Braslow D. Homicidal Ideation Causally Related to Therapeutic Medications https://bit.ly/3x7yjtw  Ethical Human Psychology and Psychiatry, Volume 10, Number 3, 2008
2. Marks DH. Depression leading to suicide as an adverse effect of metoclopramide. ISP Gastroenterology 2006 (5.2)  https://bit.ly/3x8dYEs