In Medscape’s
interview with Dr. Jan A. Fawcett, the following points were discussed by the doctor in response to the interview
questions of Jessica Gould: First, patients with bipolar disorder have higher statistics of lethal suicide attempts than the general public. This information should be considered by the
clinicians.
Second, the rapidity of mood changes in bipolar mixed state is harder to monitor. Antidepressants can enduce mood cycling thus increasing their risk for suicide. This makes it complicated for a bipolar patient’s depression to be treated while in mixed state. A patient with current agitation or rapid cycling has to be stable before his depression can be treated.
Third, if the patient experiences severe anxiety, there is high risk for him to commit suicide. However, studies about this give hope in lowering the risk for suicide since anxiety is treatable. For severe anxiety symptoms, additional treatment with clonazepam or second-generation antipsychotic medications, have proven to be effective.
Fourth, studies made to identify predictors for patients about to commit suicide have shown that there are no predictors. This poses the biggest challenge to the clinicians to obtain information that will predict patients' plans to commit suicide.
Finally, there is a constant challenge for the clinicians to find ways to treat patients who are at high risk to commit suicide.