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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).

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