Pharmacological interventions for self‐harm in adults

Drugs and natural products for self‐harm in adults
The authors have reviewed the international literature regarding pharmacological (drug) and natural product (dietary supplementation) treatment trials in the field. A total of seven trials that met inclusion criteria were identified. There is little evidence of beneficial effects of either pharmacological or natural product treatments. However, few trials have been conducted and those that have are small, meaning that possible beneficial effects of some therapies cannot be ruled out.

 
Why is this review important?
Self‐harm (SH), which includes intentional self‐poisoning/overdose and self‐injury, is a major problem in many countries and is strongly linked with suicide. It is therefore important that effective treatments for SH patients are developed. Whilst there has been an increase in the use of psychosocial interventions for SH in adults (which is the focus of a separate review), drug treatments are frequently used in clinical practice. It is therefore important to assess the evidence for their effectiveness.
 


Who will be interested in this review?
Hospital administrators (e.g. service providers), health policy officers and third party payers (e.g. health insurers), clinicians working with patients who engage in SH, patients themselves, and their relatives.

What questions does this review aim to answer?
This review is an update of a previous Cochrane Review from 2015 which found little evidence of beneficial effects of drug treatments on repetition of SH. This update aims to further evaluate the evidence for effectiveness of drugs and natural products for patients who engage in SH with a broader range of outcomes.

Which studies were included in the review?
To be included in the review, studies had to be randomised controlled trials of drug treatments for adults who had recently engaged in SH.

What does the evidence from the review tell us?
There is currently no clear evidence for the effectiveness of antidepressants, antipsychotics, mood stabilisers, or natural products in preventing repetition of SH.

What should happen next?
We recommend further trials of drugs for SH patients, possibly in combination with psychological treatment.
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