We don’t know the answer. We suspect this may be one of those questions that remain unanswered for decades to come.

But people are looking for answers to the question of suicide, especially when it comes to an increased risk associated with taking a particular prescription drug.

For instance, recently the FDA noted that certain mood stabilizer drugs increase the risk of suicidal thinking or behavior in a very small percentage of patients. These drugs are used to treat people with depression and epilepsy. And now The New York Times has an article examining whether we can really know much of anything about suicide, Making Sense of the Great Suicide Debate, when our window of analysis is so short:

But the act itself is so rare — 1 in 10,000 — that a series of drug trials cannot pick up enough cases to allow for adequate analysis. A drug trial typically lasts weeks to months and may include, at the high end, little more than a couple of hundred patients. In the case of the epilepsy drugs, the F.D.A. found 4 suicides among some 44,000 people taking the drug in 199 studies, and none among some 28,000 on placebo. Doctors would have to treat about 500 patients before seeing one case of suicidal thinking or behavior that would not have occurred without the drug.

It’s a good point. Clinical trials generally run from 6 to 8 weeks (sometimes up to a whole 16 weeks!), and rarely are long or sensitive enough to detect the incidence of suicide — even with new FDA mandates in place to do just that.

Suicide is one of those components of life that is virtually impossible to make sense of. I should know, I’ve been trying to find some sense in my best friend’s suicide, even after 17 years. That event shattered the world as I knew it, and that of his family’s, and yet there’s little sense or reasoning to it.

So yes, we should be sensitive to a slightly increased risk of possible suicidal thought or behavior for people who take medication X, Y, or Z. But we should also acknowledge that our understanding of the underlying basics of suicide still aren’t there, and it may be a very long time until they are.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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    Last reviewed: By John M. Grohol, Psy.D. on 12 Feb 2008
    Published on PsychCentral.com. All rights reserved.