Trial reportBMC medicine2009
Suicidal ideation during treatment of depression with escitalopram and nortriptyline in genome-based therapeutic drugs for depression (GENDEP): a clinical trial.
Trial report in BMC medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review.The American journal of psychiatry · 2021Pooled it
- Polymorphism A118G of opioid receptor mu 1 (OPRM1) is associated with emergence of suicidal ideation at antidepressant onset in a large naturalistic cohort of depressed outpatients.Scientific reports · 2019Trial
- A randomized controlled pilot trial of classroom-based mindfulness meditation compared to an active control condition in sixth-grade children.Journal of school psychology · 2014Trial
- Genome-wide association study of increasing suicidal ideation during antidepressant treatment in the GENDEP project.The pharmacogenomics journal · 2012Trial
- Treatment-emergent suicidal ideation during 4 months of acute management of unipolar major depression with SSRI pharmacotherapy or interpersonal psychotherapy in a randomized clinical trial.Depression and anxiety · 2011Trial
- Which PTSD clusters and symptoms are central to reducing suicidal ideation? A network and cross-lagged analysis among individuals receiving cognitive processing therapy.European journal of psychotraumatology · 2024Article
- Investigating genetic variants for treatment response to selective serotonin reuptake inhibitors in syndromal factors and side effects among patients with depression in Taiwanese Han population.The pharmacogenomics journal · 2023Article
- Polymorphisms of stress pathway genes and emergence of suicidal ideation at antidepressant treatment onset.Translational psychiatry · 2020Article
- Article
- Neurotrophin Genes and Antidepressant-Worsening Suicidal Ideation: A Prospective Case-Control Study.The international journal of neuropsychopharmacology · 2016Article
- Investigation of blood mRNA biomarkers for suicidality in an independent sample.Translational psychiatry · 2014Article
- Genetic relationships between suicide attempts, suicidal ideation and major psychiatric disorders: a genome-wide association and polygenic scoring study.American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics · 2014Article
- Do suicidal thoughts or behaviors recur during a second antidepressant treatment trial?The Journal of clinical psychiatry · 2012Article
- Review
- Antidepressant therapy in severe depression may have different effects on ego-dystonic and ego-syntonic suicidal ideation.Depression research and treatment · 2011Article
- Pharmacogenomics of suicidal events.Pharmacogenomics · 2010Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors at 8 institutions in 7 countries.
Funding
Abstract
backgroundSuicidal thoughts and behaviours during antidepressant treatment, especially during the first weeks of treatment, have prompted warnings by regulatory bodies. The aim of the present study is to investigate the course and predictors of emergence and worsening of suicidal ideation during tricyclic antidepressant and serotonin reuptake inhibitor treatment.
methodsIn a multicentre part-randomised open-label study, 811 adult patients with moderate to severe unipolar depression were allocated to flexible dosage of escitalopram or nortriptyline for 12 weeks. The suicidality items of three standard measures were integrated in a suicidal ideation score. Increases in this score were classified as treatment emergent suicidal ideation (TESI) or treatment worsening suicidal ideation (TWOSI) according to the absence or presence of suicidal ideation at baseline.
resultsSuicidal ideation decreased during antidepressant treatment. Rates of TESI and TWOSI peaked in the fifth week. Severity of depression predicted TESI and TWOSI. In men, nortriptyline was associated with a 9.8-fold and 2.4-fold increase in TESI and TWOSI compared to escitalopram, respectively. Retirement and history of suicide attempts predicted TWOSI.
conclusionIncreases in suicidal ideation were associated with depression severity and decreased during antidepressant treatment. In men, treatment with escitalopram is associated with lower risk of suicidal ideation compared to nortriptyline. Clinicians should remain alert to suicidal ideation beyond the initial weeks of antidepressant treatment.
trial registrationEudraCT (No.2004-001723-38) and ISRCTN (No. 03693000).
Indexed as
Identifiers
What OpenQuestion holds
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.