ArticlePharmacoepidemiology and drug safety2015
Antidepressant treatment and suicide attempts and self-inflicted injury in children and adolescents.
Article in Pharmacoepidemiology and drug safety, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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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
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Risk of Suicidal Behaviors and Antidepressant Exposure Among Children and Adolescents: A Meta-Analysis of Observational Studies.Frontiers in psychiatry · 2022Pooled it
- Comparative efficacy and acceptability of antidepressants, psychotherapies, and their combination for acute treatment of children and adolescents with depressive disorder: a systematic review and network meta-analysis.The lancet. Psychiatry · 2020Pooled it
- Risk Factors Associated With Peripartum Suicide Attempts in Japan.JAMA network open · 2023Article
- Chronic exposure to fluoxetine of female mice before mating causes impaired stress resilience in female offspring.Journal of neural transmission (Vienna, Austria : 1996) · 2019Article
- Challenges in the diagnosis and treatment of pediatric obsessive-compulsive disorder.Indian journal of psychiatry · 2019Review
- Dosing and Monitoring: Children and Adolescents.Psychopharmacology bulletin · 2018Review
- Variation in the 12-Month Treatment Trajectories of Children and Adolescents After a Diagnosis of Depression.JAMA pediatrics · 2018Article
- ADHD Medication and Substance-Related Problems.The American journal of psychiatry · 2017Article
- Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology.Journal of psychopharmacology (Oxford, England) · 2016Article
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6 authors.
Funding
Abstract
purposeIn the 2004, FDA placed a black box warning on antidepressants for risk of suicidal thoughts and behavior in children and adolescents. The purpose of this paper is to examine the risk of suicide attempt and self-inflicted injury in depressed children ages 5-17 treated with antidepressants in two large observational datasets taking account time-varying confounding.
methodsWe analyzed two large US medical claims databases (MarketScan and LifeLink) containing 221,028 youth (ages 5-17) with new episodes of depression, with and without antidepressant treatment during the period of 2004-2009. Subjects were followed for up to 180 days. Marginal structural models were used to adjust for time-dependent confounding.
resultsFor both datasets, significantly increased risk of suicide attempts and self-inflicted injury were seen during antidepressant treatment episodes in the unadjusted and simple covariate adjusted analyses. Marginal structural models revealed that the majority of the association is produced by dynamic confounding in the treatment selection process; estimated odds ratios were close to 1.0 consistent with the unadjusted and simple covariate adjusted association being a product of chance alone.
conclusionsOur analysis suggests antidepressant treatment selection is a product of both static and dynamic patient characteristics. Lack of adjustment for treatment selection based on dynamic patient characteristics can lead to the appearance of an association between antidepressant treatment and suicide attempts and self-inflicted injury among youths in unadjusted and simple covariate adjusted analyses. Marginal structural models can be used to adjust for static and dynamic treatment selection processes such as that likely encountered in observational studies of associations between antidepressant treatment selection, suicide and related behaviors in youth.
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