ADHD medication may reduce suicidal risk among Borderline Personality Disorder patients

This study entitled “Comparative Effectiveness of Pharmacotherapies for the Risk of Attempted or Completed Suicide Among Persons With Borderline Personality Disorder” by Johannes Lieslehto, MD, PhD and colleagues is published in JAMA Network Open.

Among BPD individuals, Suicidal behaviour is a significant clinical concern. Data are scarce regarding the effectiveness of pharmacotherapy in reducing suicide risk, and it requires detailed research. The researchers of the present study further researched this background.

The key findings of the study are:

• The data was used from nationwide Swedish register databases.
• There were 22 601 BPD patients with a mean age of 29.2 years.
• The hazard ratio (HR) for attempted or completed suicide was the primary outcome.
• Eight thousand five hundred thirteen hospitalizations due to attempted suicide and 316 completed suicides were observed.
• Using ADHD medication reduces suicidal behaviour risk.
• Treatment with mood stabilizers did not affect the main outcome.
• Antidepressant and antipsychotic treatments elevate the risk of attempted or completed suicide.
• Benzodiazepines had the highest risk of attempted or completed suicide.

In this Swedish nationwide cohort, ADHD medication was the only pharmacological treatment that reduced the risk of suicidal behaviour among BPD patients.

Benzodiazepines should be used with care among such patients as it has a high risk of suicide.

Our study adds to the literature by providing insight concerning pharmacotherapy and suicide risk, which is a major clinical challenge for treating BPD, they said.

Further reading:

Lieslehto J, Tiihonen J, Lähteenvuo M, Mittendorfer-Rutz E, Tanskanen A, Taipale H. Comparative Effectiveness of Pharmacotherapies for the Risk of Attempted or Completed Suicide Among Persons With Borderline Personality Disorder. JAMA Netw Open. 2023;6(6):e2317130. doi:10.1001/jamanetworkopen.2023.17130