Medications Associated with Mood Swings and Suicidal Ideation

Antidepressants

Selective Serotonin Reuptake Inhibitors (SSRIs) have been associated with an increased risk of suicidal ideation and nonfatal suicide attempts, particularly in the initial treatment period, according to the American College of Physicians, as published in the Annals of Internal Medicine 1
The American Academy of Child and Adolescent Psychiatry recommends that case reports have specifically identified fluoxetine as potentially inducing suicidal preoccupations in some patients, especially when treatment is first initiated 2
Patients experiencing akathisia (restlessness) as a side effect of SSRIs may be at higher risk for developing suicidal ideation, as reported by the American Academy of Child and Adolescent Psychiatry 2
Paroxetine has been associated with higher rates of sexual dysfunction and mood changes compared to other antidepressants, according to the American College of Physicians, as published in the Annals of Internal Medicine 1

The American Diabetes Association notes that Naltrexone/bupropion combination carries a black box warning for suicidal behavior/ideation specifically in people younger than 24 years old who have depression 3
The American Diabetes Association also reports that Topiramate, used for seizures and weight management, has been associated with mood changes 3

The British Medical Association states that Carbamazepine has been linked to mood alterations and psychological side effects, as published in the BMJ 5

The American Academy of Child and Adolescent Psychiatry recommends that Benzodiazepines may disinhibit some individuals who then exhibit aggression and suicide attempts 2
The American Academy of Child and Adolescent Psychiatry also notes that Phenobarbital has been associated with reduced self-control and potential suicidal behavior 2

The American Academy of Child and Adolescent Psychiatry reports that Amphetamines have been linked to potential disinhibition and suicidal behavior in some individuals 2
The American Academy of Child and Adolescent Psychiatry recommends that Stimulant medications should be prescribed only when treating patients with ADHD, and with careful monitoring 2

The American Academy of Child and Adolescent Psychiatry recommends that for patients on SSRIs, clinicians should be particularly observant during the early stages of treatment 2
The American Academy of Child and Adolescent Psychiatry states that systematic inquiry about suicidal ideation before and after treatment is started is essential 2
The American Academy of Child and Adolescent Psychiatry notes that be especially alert to the possibility of suicidality if treatment is associated with the onset of akathisia 2
The American Academy of Child and Adolescent Psychiatry recommends that all medication administration for patients with suicidal tendencies must be carefully monitored by a third party who can report any unexpected change of mood, increase in agitation, or unwanted side effects 2

The American College of Clinical Pharmacy notes that for patients with weight concerns, consider that mirtazapine and paroxetine are associated with greater weight gain, while bupropion is consistently associated with weight loss, as reported by Praxis Medical Insights 6