NEW YORK (Reuters Health) - In patients with severe or "major" depression, adding the antipsychotic drug risperidone to their antidepressant therapy seems to reduce suicidal thoughts.

In the Journal of Clinical Psychiatry, Dr. Xiaohua Li of the University of Alabama at Birmingham and colleagues point out that antidepressant therapy by itself is often not sufficient for the treatment of risk-taking symptoms of depression.

To investigate whether risperidone might be helpful, the researchers studied 24 patients with suicidal thoughts who were randomly assigned to receive risperidone or an inactive "placebo" in addition to their antidepressant therapy.

Using the Beck Scale for Suicidal Ideation (BSSI) and other doctor- and self-rated tests, the team found that risperidone led to a significant reduction in thoughts of suicide which continued throughout the 8-week treatment period.

Both placebo and risperidone achieved a 22 percent reduction in average BSSI scores in the first week. However, only in the risperidone group was there a further reduction in BSSI score between the first and last week.

Risperidone also improved other symptoms such as impulsivity that seem to be related to a person's risk of suicide.

Commenting on the findings, Li told Reuters Health that effective drug treatment for the suicidal thoughts that often accompany major depression remains to be established. The anti-suicidal effect of risperidone found in this study is especially valuable for the short-term treatment of suicidal thinking and other severe depressive symptoms. Because this study was small, larger studies are needed to verify the results and to assess the benefits of other antipsychotics in reducing suicidal thoughts in depressed patients, the authors add.

SOURCE: Journal of Clinical Psychiatry, August 2008.