Non-suicidal self-injury (NSSI) is the intentional damaging of one’s tissue without suicidal intent. NSSI most commonly occurs in children and adolescents, and more women than men report engaging self-injury. Engagement in NSSI increases likelihood of psychiatric hospitalization, future suicidal ideation, and suicide attempts. Therefore, providing effective treatment for individuals using NSSI is extremely important to improve quality of life, and psychiatric outcomes (Eggart et al., 2022).
Pharmacological intervention is often a first-line treatment for those engaging in NSSI, especially when it is comorbid with another psychiatric illness. A wide variety of psychotropic drugs are prescribed to adolescents to treat a variety of psychiatric illnesses, and prescription depends on symptoms and medical history of the patient. The most widely prescribed drug classes for treatment of NSSI include selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, anti-psychotics, mood stabilizers, and anti-convulsants.
Eggart et al. (2022) conducted a systematic review of literature to examine the most prescribed and most effective pharmacological treatment of NSSI in children and adolescents. Meta-analyses demonstrated no significant differences in NSSI engagement in youth treated with SSRIs versus a placebo. Furthermore, SSRIs can increase suicidality and NSSI urges in adolescents, and therefore must be prescribed carefully. Benzodiazepines were shown to increase NSSI urges in adolescents, while a small study of adolescent females demonstrated a decrease in NSSI engagement when taking antipsychotics.
Eggart et al. concluded that pharmacotherapy results for NSSI specifically are mixed. SSRIs are the most widely prescribed class of drugs for depression, and while individuals with depression have a higher likelihood of engaging in NSSI, it does not appear that SSRIs impact engagement of NSSI specifically. Researchers emphasized that this preliminary review underscores the need for more research on the impact of pharmacotherapy on NSSI engagement, as there is currently no pharmacological treatment for NSSI specifically.
Citation:
Eggart, V., Cordier, S., Hasan, A., & Wagner, E. (2022). Psychotropic drugs for the treatment of non-suicidal self-injury in children and adolescents: A systematic review and meta-analysis. European Archives of Psychiatry and Clinical Neuroscience. https://doi-org.ezproxy.library.uvic.ca/10.1007/s00406-022-01385-w
