Tranquilizers and Suicide in the Schizophrenic Patient

Introduction Soon after the introduction of reserpine and chlorpromazine a decade ago questions arose concerning the relationship between the tranquilizing drugs and suicide. A number of clinicians have reported an increased incidence of suicide in drug-treated patients. Reserpine and other rauwolfia compounds were particularly suspect. Even in the small doses employed to treat hypertension, depression was noted in 15%-25% of the patients.1,2However, it was also recognized that the drug was only one contributory factor in the affectual change. Perfectionistic, obsessive-compulsive personalities seemed predisposed to depression. In Ayd's opinion3the depression had sometimes existed prior to treatment but had not been diagnosed. In other instances he described "pseudo-depressions" in which the drug's pharmacologic action induced lethargy, psychomotor retardation, and anergy. Bernstein and Kaufman4believed that the increased passivity of the reserpine-treated patient produced affectual blunting in certain patients vulnerable to