| Antidepressants | Short-term benefits are not clear; long-term effects are virtually untested | Research findings are inconclusive. Suicidal risk may increase with agitation, and in youth but may be lower in older adults | Studies lack long-term randomization with suicidal acts as an explicit outcome measure |
| Antipsychotics | Short-term benefits are not adequately tested. Clozapine is probably beneficial long-term in schizophrenia (with FDA approval) but untested in BD | Except for clozapine, testing remains inadequate and inconclusive | Effects of clozapine rely mainly on a single randomized trial vs. olanzapine, without reduction of mortality |
| Anticonvulsants | Short-term effects are not established; long-term benefits have been proposed | Valproate most studied; anticonvulsants may be less effective than lithium | Studies lack suicidal acts as an explicit outcome |
| Lithium | Very likely effective long-term | Consistent decrease of risk of suicide and attempts in controlled and uncontrolled studies; not clear if effect is via reducing risk of depression, impulsivity, or specific anti-suicidal action | Even randomized trials lack suicidal behavior as explicit outcome measure. Long-term acceptance and tolerance suggests some self-selection; potentially toxic on overdose |
| Other pharmacological treatments | Only short-term effects have been tested | Ketamine can reduce suicidal ideation; effects on suicidal behavior are untested; newer NMDA agents untested | Ketamine has a short-term antidepresant effect in BD |
| Other somatic treatments | If there are benefits, they are probably short-term | ECT, magnetic, vagal nerve, or deep-brain stimulations can benefit depression | Inadequate testing vs. suicidal behavior specifically |
| Psychotherapies | Effects not established, but widely assumed to be helpful clinically | Cognitive-behavioral, dialectic and interpersonal methods best studied, but research results for suicide are inconclusive | Psychotherapy involves self-selection |
