Table 1.

Summary of reports on modern antipsychotic drugs and outcomes related to suicidal risk or depression.

Study	Subjects (n)	Diagnosis	Study Design	Comparison Treatment	Outcome Measure	Risk Reduction	Comments
Aripiprazole
Weisler et al. 2011 [89]	737	MDD	Pooled RCTs	Placebo	Suicidal ideation	–––	Ariprazole effective
Ringbäck-Weitoft et al. 2014 [44]	720	Sz	National database	APs, SGAs	Suicide	OR: 0.21 [0.05–0.94]	Ariprazole effective
Asenapine
Azorin et al. 2013 [87]	295	BD-I	Pooled RCTs	Olanzapine	Depression	–––	Asenapine effective vs. depression & suicidal ideation
Clozapine
Meltzer et al. 2003 [38]	980	Sz	RCT	Olanzapine	Suicidal behavior	HR: 0.76 [0.58–0.97]	Clozapine superior
Modestin et al. 2005 [43]	94	Sz	Chart review	±ADs	Suicidal behavior	–––	Clozapine effective ± antidepressants
Haukka et al. 2008 [4]	504	Sz	National database	No treatment	Suicide	HR: 0.74 [0.35–1.57]	Clozapine reduced mortality
Tiihonen et al. 2009 [5]	32,000	Sz	National database	Perphenazine	Suicide	HR: 0.34 [0·20–0·57]	Clozapine reduced mortality
Ringbäck-Weitoft et al. 2014 [44]	2138	Sz	National database	APs, SGAs	Suicidal behavior	OR: 0.45 [0.20-0.98]	Clozapine more effective than haloperidol
Thomas et al. 2015 [16]	–––	Sz	Open trial	Olanzapine	Suicide attempt	–––	Clozapine more effective than olanzapine vs. suicide attempts
Olanzapine
Tollefson et al. 1997 [49]	1996	Sz	RCT	Haloperidol	Negative symptoms	–––	Olanzapine more effective vs. suicidal ideation & negative symptoms
Tran et al. 1997 [48]	339	Sz	RCT	Risperidone	Negative symptoms	–––	Olanzapine more effective vs. suicidal ideation & negative symptoms
Barak et al. 2004 [50]	756	Sz	Case-control chart review	Risperidone or Neuroleptics	Suicide attempt	OR: 0.57 [0.30–0.83]	Olanzapine & risperidone more effective than neuroleptics
Haukka et al. 2008 [4]	394	Sz	National database	No treatment	Suicide attempt	HR: 1.37 [0.87–2.14]	Olanzapine effective
Tiihonen et al. 2009 [5]	25,130	Sz	National database	Perphenazine	Suicide	HR: 0.94 [0·61–1·45]	Olanzapine more effective
Ringbäck-Weitoft et al. 2014 [44]	3747	Sz	National database	APs, SGAs	Suicide attempt	OR: 0.44 [0.28-0.70]	Olanzapine more effective
Quetiapine
Calabrese et al. 2005 [62]	511	BD-I+II	RCT	Placebo	Suicidal thoughts	–––	Quetiapine more effective
Cutler et al. 2009 [66]	612	MDD	RCT	Placebo	Suicidal thoughts	–––	Quetiapine (150–300 mg/day) effective
Suppes et al. 2009 [65]	1953	BD-I	RCT	Placebo	Depression	–––	Quetiapine + lithium or + divalproex reduced new depression 67%
Tiihonen et al. 2009 [5]	5360	Sz	National database	Perphenazine	Suicide	OR: 1.58 [0.89–2.79]	Quetiapine not effective
El-Khalili et al. 2010 [70]	446	BD-I+II	RCT	Placebo	Suicidal thoughts	–––	Quetiapine effective for suicidal thoughts, tension, insomnia
McElroy et al. 2010 [64]	740	BD-I+II	RCT	Placebo	Depression	–––	Quetiapine more effective vs. suicidal ideation & depression
Young et al. 2010 [63]	802	BD-I+II	RCT	Placebo	Depression	–––	Quetiapine effective vs. suicidal thoughts, tension, insomnia
Weisler et al. 2014 [71]	1766	MDD	Pooled RCTs	Placebo	Suicidal behavior	–––	No emergent suicidal behavior (drug or placebo)
Ziprasidone
Karayal et al. 2011 [79]	5123	BD-I+II	Pooled RCTs	Placebo	Suicidal behavior	–––	No emergent suicidal behavior (drug or placebo)

Abbreviations: AD, antidepressant; AP, antipsychotic; BD, bipolar disorder (type I or II); HR, Hazard Ratio; MDD, major depressive disorder; OR, Odds Ratio; SGA, second-generation antipsychotic; Sz, schizophrenia; RCT: randomized controlled trial; –––, no information. The 24 comparisons summarized here arise from 19 reports [4,5,38,43,44,46,48,49,50,62,63,64,65,66,70,71,79,87,89], and include over 86,896 subjects.