MISSD urges suicide prevention leaders to screen for medication-related distress

At a regional suicide prevention forum in Costa Rica, MISSD pressed clinicians and crisis responders to consider adverse drug effects, including akathisia, when assessing sudden distress or suicidal risk. The group says routine medication questions could help prevent missed warning signs and improve crisis response.

Why it matters: - Medication-related distress can look like anxiety, agitation or worsening mental illness. - MISSD says those symptoms may point to adverse drug effects that can contribute to self-harm, violence or suicide. - Adding medication questions to suicide prevention work may help clinicians spot a different cause sooner and choose a more appropriate response.

What happened: - The Medication-Induced Suicide Prevention and Education Foundation in Memory of Stewart Dolin, known as MISSD, presented at the International Association for Suicide Prevention’s Pan-America Regional Forum in San José, Costa Rica. - Kristina Kaiser, MISSD’s director of communication and education, gave a presentation titled “Recognizing Akathisia in Suicide Prevention Across the Americas: Training for Clinicians, Suicidologists, and Crisis Responders.” - The presentation urged professionals to ask whether distress began or intensified after a medication was started, stopped or changed.

The details: - Akathisia can involve intense inner restlessness, an overwhelming need to move and severe agitation. - The condition has been reported with psychiatric medications and some medications prescribed for other conditions. - MISSD said akathisia can be mistaken for anxiety, behavioral disturbance or worsening illness. - The group outlined three practical screening questions for clinical and crisis settings: Has a medication recently been started, stopped or changed? Did distress begin or worsen afterward? Is the person experiencing intense inner restlessness? - MISSD said those questions supplement established suicide-risk assessments and do not replace them. - Crisis responders are not expected to diagnose akathisia, but they can recognize when symptoms warrant prompt clinical evaluation and medication review. - Kaiser said clinicians should ask what changed before the distress began, not only what the person is experiencing. - Kaiser said a medication history can reveal information that might otherwise be missed when distress is attributed solely to a psychiatric condition.

Between the lines: - MISSD is pushing a broader definition of suicide prevention that includes medication safety, not just psychiatric screening. - The message is aimed at both clinicians and frontline crisis workers, suggesting the foundation sees gaps at multiple points in the care pathway. - Following the presentation, a Canadian psychiatrist told MISSD it was the first presentation on akathisia he had seen and welcomed the attention to the topic. - Wendy Dolin, MISSD founder, said sudden or severe distress should prompt consideration of possible adverse drug effects and that patients and families need to be heard.

What's next: - MISSD wants crisis hotlines to make medication questions a routine part of their assessment protocols. - The foundation is also urging organizations to include akathisia recognition in professional training. - MISSD wants to expand collaboration on accessible English- and Spanish-language educational resources. - MISSD says it offers free online akathisia courses, public health videos, podcasts and lived-experience resources for healthcare professionals, patients, families and crisis responders.

The bottom line: - MISSD is asking suicide prevention systems to treat medication changes as a routine part of risk assessment, especially when distress appears suddenly or unusually severe.