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Pharmacological interventions for self-harm in adults
Keith Hawton1, Katrina G Witt, Tatiana L Taylor Salisbury
1Centre for Suicide Research, University Department of Psychiatry, Warneford Hospital, Oxford, UK, OX3 7JX.
The Cochrane Database of Systematic Reviews
|July 7, 2015
Summary
Pharmacological treatments show no significant effect on reducing self-harm repetition in adults, with limited evidence and small trials. Further research is needed to evaluate treatments like flupenthixol and atypical antipsychotics.
Area of Science:
- Psychiatry
- Clinical Pharmacology
Background:
- Self-harm (SH) is a prevalent issue, often recurrent and linked to suicide.
- This review focuses on pharmacological interventions for adults experiencing self-harm.
Purpose of the Study:
- To identify and analyze randomized controlled trials (RCTs) of pharmacological agents for self-harm in adults.
- To conduct meta-analyses comparing treatments against placebo or alternative pharmacological options.
Main Methods:
- Searched major databases (MEDLINE, EMBASE, PsycINFO, CENTRAL) and the Cochrane Depression, Anxiety and Neurosis Register.
- Included RCTs of pharmacological treatments or natural products for recent self-harm episodes.
- Analyzed data using odds ratios (ORs) and mean differences (MDs); meta-analysis was limited to newer generation antidepressants.
Main Results:
- Seven trials with 546 participants were included.
- No significant effect on self-harm repetition was found for newer generation antidepressants, low-dose fluphenazine, mood stabilizers, or natural products.
- A single trial suggested a reduction in self-harm with flupenthixol, but evidence quality was very low.
Conclusions:
- The low quality and limited number of trials preclude firm conclusions on pharmacological interventions for self-harm.
- Larger trials are needed, potentially evaluating atypical antipsychotics and combined treatments.
- Future research should also assess adverse effects of pharmacological agents.