ArticleArchives of general psychiatry2010
Variation in the risk of suicide attempts and completed suicides by antidepressant agent in adults: a propensity score-adjusted analysis of 9 years' data.
Article in Archives of general psychiatry, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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
23 citing papers in PubMed, 73 citations in OpenAlex.
- Association between mirtazapine use and serious self-harm in people with depression: an active comparator cohort study using UK electronic health records.Evidence-based mental health · 2022Article
- Patients Who Die by Suicide: A Study of Treatment Patterns and Patient Safety Incidents in Norway.International journal of environmental research and public health · 2022Article
- Do clinicians follow heuristics in prescribing antidepressants?Journal of affective disorders · 2022Article
- Suicidal Behavior and Its Relationship with Postmortem Forensic Toxicological Findings.Toxics · 2022Article
- Antidepressant Use and Suicide Rates in Adults Aged 75 and Above: A Swedish Nationwide Cohort Study.Frontiers in public health · 2021Article
- Adherence to psychotropic medication in completed suicide in Sweden 2006-2013: a forensic-toxicological matched case-control study.European journal of clinical pharmacology · 2019Article
- Longterm persistence and nonrecurrence of depression treatment in Germany: a four-year retrospective follow-up using linked claims data.International journal of methods in psychiatric research · 2018Article
- Automated data-adaptive analytics for electronic healthcare data to study causal treatment effects.Clinical epidemiology · 2018Review
- Monitoring of suicide risk throughout the course of treatment with antidepressants for depression is required, but vigilance is required for those on some particular antidepressant agents.Evidence-based mental health · 2015Article
- Suicide Behavior Before and After the Start with Antidepressants: A High Persistent Risk in the First Month of Treatment Among the Young.The international journal of neuropsychopharmacology · 2015Observational
- Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: cohort study using a primary care database.BMJ (Clinical research ed.) · 2015Article
- Revisiting the washout period in the incident user study design: why 6-12 months may not be sufficient.Journal of comparative effectiveness research · 2015Article
- Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study.BMJ (Clinical research ed.) · 2014Article
- How complete are E-codes in commercial plan claims databases?Pharmacoepidemiology and drug safety · 2014Article
- Antidepressant class, age, and the risk of deliberate self-harm: a propensity score matched cohort study of SSRI and SNRI users in the USA.CNS drugs · 2014Article
- A prospective naturalistic study of antidepressant-induced jitteriness/anxiety syndrome.Neuropsychiatric disease and treatment · 2014Article
- The use of clinical trials in comparative effectiveness research on mental health.Journal of clinical epidemiology · 2013Article
- Antidepressant agents and suicide death among US Department of Veterans Affairs patients in depression treatment.Journal of clinical psychopharmacology · 2012Article
- Factors related to suicide attempts among individuals with major depressive disorder.International journal of general medicine · 2012Article
- Propensity score-based sensitivity analysis method for uncontrolled confounding.American journal of epidemiology · 2011Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
contextA US Food and Drug Administration advisory has warned that antidepressants may be associated with an increased risk of suicidal thoughts and behaviors in adolescents. This prompted a meta-analysis of trials in adults that found no overall increase in risk, but individual agents could not be studied.
objectiveTo assess the risk of suicide and suicide attempts associated with individual antidepressant agents.
designCohort study of incident users of antidepressant agents.
settingPopulation-based health care utilization data of all residents of British Columbia, Canada, aged 18 years and older between January 1, 1997, and December 31, 2005. PATIENTS: British Columbia residents who had antidepressant therapy initiated and had a recorded diagnosis of depression.
interventionInitiation of various antidepressant medications.
main outcome measuresCombined suicide death or hospitalization due to self-harm.
resultsIn a population of 287,543 adults aged 18 years and older with antidepressant therapy initiated, we observed outcome rates ranging from 4.41/1000 person-years to 9.09/1000 person-years. Most events occurred in the first 6 months after treatment initiation. After extensive propensity score adjustment, we found no clinically meaningful variation in the risk of suicide and suicide attempt between antidepressant agents compared with fluoxetine hydrochloride initiation: citalopram hydrobromide, hazard ratio = 1.00 (95% confidence interval, 0.63-1.57); fluvoxamine maleate, hazard ratio = 0.98 (95% confidence interval, 0.63-1.51); paroxetine hydrochloride, hazard ratio = 1.02 (95% confidence interval, 0.77-1.35); and sertraline hydrochloride, hazard ratio = 0.75 (95% confidence interval, 0.53-1.05). Compared with selective serotonin reuptake inhibitors as a drug class, other classes including serotonin-norepinephrine reuptake inhibitors, tricyclic agents, and other newer and atypical agents had a similar risk. Restriction to patients with no antidepressant use in the past 3 years further reduced apparent differences between groups.
conclusionsOur finding of equal event rates across antidepressant agents supports the US Food and Drug Administration's decision to treat all antidepressants alike in their advisory. Treatment decisions should be based on efficacy, and clinicians should be vigilant in monitoring after initiating therapy with any antidepressant agent.
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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.