ArticlePloS one2013
An association between initiation of selective serotonin reuptake inhibitors and suicide - a nationwide register-based case-crossover study.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis 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.
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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.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 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
- Antiviral treatment perspective against Borna disease virus 1 infection in major depression: a double-blind placebo-controlled randomized clinical trial.BMC pharmacology & toxicology · 2020Trial
- Age-Dependent Analysis of Suicidal Ideation, Suicide Attempts, and Suicides Associated with SSRI and SNRI Drugs Based on Pharmacovigilance Data.Pharmaceuticals (Basel, Switzerland) · 2024Article
- Effect of selective serotonin reuptake inhibitor treatment following diagnosis of depression on suicidal behaviour risk: a target trial emulation.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2023Article
- Drug Safety and Suicidality Risk of Chronic Pain Medications.Pharmaceuticals (Basel, Switzerland) · 2023Review
- Clinician-recalled quoted speech in electronic health records and risk of suicide attempt: a case-crossover study.BMJ open · 2020Article
- Concurrent use of benzodiazepines, antidepressants, and opioid analgesics with zolpidem and risk for suicide: a case-control and case-crossover study.Social psychiatry and psychiatric epidemiology · 2019Article
- Adherence to psychotropic medication in completed suicide in Sweden 2006-2013: a forensic-toxicological matched case-control study.European journal of clinical pharmacology · 2019Article
- Antidepressant prescription rates and suicide attempt rates from 2004 to 2016 in a nationally representative sample of adolescents in the USA.Epidemiology and psychiatric sciences · 2019Article
- The association between antidepressant use and deaths from road traffic accidents: a case-crossover study.Social psychiatry and psychiatric epidemiology · 2019Article
- Selective serotonin re-uptake inhibitors and the risk of violent suicide: a nationwide postmortem study.European journal of clinical pharmacology · 2019Article
- Methodological Flaws, Conflicts of Interest, and Scientific Fallacies: Implications for the Evaluation of Antidepressants' Efficacy and Harm.Frontiers in psychiatry · 2017Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment with selective serotonin reuptake inhibitors (SSRI) is one of the most common treatments for depression. It is however not clear whether or not there is an increased short-term suicide risk during initiation with SSRI.
methodsA register-based nationwide case-crossover study including 5,866 suicides, 1,698 women and 4,168 men, from the Death Register 2007-2010 in Sweden. SSRI initiation was defined as a dispensed prescription of SSRI within 28 days prior to the date of suicide with no previous dispensed prescription of SSRI within 4 months prior that prescription. The control period took place one year earlier. Odds ratio (OR) was estimated using conditional logistic regression.
resultDuring the 28 day period prior to suicide 48 women and 138 men were exposed to SSRI initiation (while not being exposed in the control period) and 22 women and 43 men were exposed in the control period (while not being exposed in the case period). The OR for suicide after initiation with SSRI was 2.7 (95% CI: 1.6-44) for women, and 4.3 (95% CI: 3.0-6.1) for men. The highest OR was found 8-11 days after initiation with SSRI 9.7 (95% CI: 3.0-31.7) for women and men combined.
conclusionThe main limitation in this study is confounding by indication, but the descriptive question is however not confounded by indication. Together with plausible biological mechanisms and previous clinical and epidemiological observations our findings, linking initiation of SSRI to increased short-term suicide risk, deserve further attention specifically in the clinical setting.
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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.