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Self-Harm: Longer-Term Management

Self-Harm: Longer-Term Management

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK)

Version: 2012

PHARMACOLOGICAL INTERVENTIONS

Many people who self-harm take psychotropic medication (Murphy et al., 2007), often as treatment for associated conditions such as depression. However evidence for the efficacy of pharmacological interventions to reduce self-harm is lacking. Some research suggests that lithium and clozapine may have specific anti-suicidal properties (Cipriani et al., 2005; Meltzer et al., 2003). Other studies have reported that prescription of certain classes of antidepressants (for example, selective serotonin reuptake inhibitors [SSRIs]) may be associated with an increase in suicidal behaviour particularly in young people (Barbui et al., 2009; Fergusson et al., 2005). Those who self-harm are at increased risk of future episodes, including overdoses of medication. There are large differences in the toxicity of medication prescribed to people who self-harm (Hawton et al., 2010).

EXPERIENCE OF CARE

This chapter provides an overview of the experience of people who self-harm including different age groups such as young people and adults, and special groups such as those with mild learning disabilities, males or those with borderline personality disorder, and their families/carers.

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