ArticleBMJ (Clinical research ed.)2005
Antidepressant treatment and the risk of fatal and non-fatal self harm in first episode depression: nested case-control study.
Article in BMJ (Clinical research ed.), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
67 citing papers in PubMed, 7 syntheses or guidelines pooled it, 242 citations in OpenAlex.
- Risk of Suicidal Behaviors and Antidepressant Exposure Among Children and Adolescents: A Meta-Analysis of Observational Studies.Frontiers in psychiatry · 2022Pooled it
- Risk of suicidality in clinical trials of antidepressants in adults: analysis of proprietary data submitted to US Food and Drug Administration.BMJ (Clinical research ed.) · 2009Pooled it
- Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2009Pooled it
- Comparative risk for harms of second-generation antidepressants : a systematic review and meta-analysis.Drug safety · 2008Pooled it
- Depression in adults: drug and physical treatments.BMJ clinical evidence · 2007Pooled it
- Is there evidence for negative effects of antidepressants on suicidality in depressive patients? A systematic review.European archives of psychiatry and clinical neuroscience · 2006Pooled it
- Pooled it
- Suicidal ideation during treatment of depression with escitalopram and nortriptyline in genome-based therapeutic drugs for depression (GENDEP): a clinical trial.BMC medicine · 2009Trial
- Trajectories of antidepressant dispensing among privately insured transgender people in the United States.Scientific reports · 2026Article
- Review
- Swiss GPs' preferences for antidepressant treatment in mild depression: vignette-based quantitative analysis.BMC family practice · 2021Article
- Real-world effect of antidepressants for depressive disorder in primary care: protocol of a population-based cohort study.Evidence-based mental health · 2020Article
- Suicidal Ideation and Suicidal Behavior as Rare Adverse Events of Antidepressant Medication: Current Report from the AMSP Multicenter Drug Safety Surveillance Project.The international journal of neuropsychopharmacology · 2018Article
- Antidepressant use and risk of adverse outcomes in people aged 20-64 years: cohort study using a primary care database.BMC medicine · 2018Article
- Antidepressant use in suicides: a case-control study from the Friuli Venezia Giulia Region, Italy, 2005-2014.European journal of clinical pharmacology · 2017Article
- Temporal trends in antidepressant prescribing to children in UK primary care, 2000-2015.Journal of affective disorders · 2017Article
- Lifestyle factors, psychiatric and neurologic comorbidities, and drug use associated with incident seizures among adult patients with depression: a population-based nested case-control study.European journal of epidemiology · 2016Article
- Article
- Antidepressant use and risk of cardiovascular outcomes in people aged 20 to 64: cohort study using primary care database.BMJ (Clinical research ed.) · 2016Observational
- Antidepressant use and risk of epilepsy and seizures in people aged 20 to 64 years: cohort study using a primary care database.BMC psychiatry · 2015Observational
7 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the risk of non-fatal self harm and suicide in patients taking selective serotonin reuptake inhibitors (SSRIs) with that of patients taking tricyclic antidepressants, as well as between different SSRIs and different tricyclic antidepressants.
designNested case-control study.
settingPrimary care in the United Kingdom.
participants146,095 individuals with a first prescription of an antidepressant for depression.
main outcome measuresSuicide and non-fatal self harm.
results1968 cases of non-fatal self harm and 69 suicides occurred. The overall adjusted odds ratio of non-fatal self harm was 0.99 (95% confidence interval 0.86 to 1.14) and that of suicide 0.57 (0.26 to 1.25) in people prescribed SSRIs compared with those prescribed tricyclic antidepressants. We found little evidence that associations differed over time since starting or stopping treatment. We found some evidence that risks of non-fatal self harm in people prescribed SSRIs compared with those prescribed tricyclic antidepressants differed by age group (interaction P = 0.02). The adjusted odds ratio of non-fatal self harm for people prescribed SSRIs compared with users of tricylic antidepressants for those aged 18 or younger was 1.59 (1.01 to 2.50), but no association was apparent in other age groups. No suicides occurred in those aged 18 or younger currently or recently prescribed tricyclic antidepressants or SSRIs.
conclusionWe found no evidence that the risk of suicide or non-fatal self harm in adults prescribed SSRIs was greater than in those prescribed tricyclic antidepressants. We found some weak evidence of an increased risk of non-fatal self harm for current SSRI use among those aged 18 or younger. However, preferential prescribing of SSRIs to patients at higher risk of suicidal behaviour cannot be ruled out.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.