Evidence map›Paper›PMID 36042093›Full record

ArticleJournal of general internal medicine2022

Long-term Psychoactive Medications, Polypharmacy, and Risk of Suicide and Unintended Overdose Death Among Midlife and Older Women Veterans.

Carolyn J Gibson, Yixia Li, Guneet K Jasuja, Salomeh Keyhani, Amy L Byers

Open access · hybridAbstract read
In one paragraph

Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Developing Longitudinal Post-Overdose Care: A Call to Action.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026
    Article
  3. Observational
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Carolyn J GibsonSan Francisco VA Health Care System, 4150 Clement Street, 116P, San Francisco, CA, 94121, USA. Carolyn.Gibson2@va.gov.ORCID 0000-0001-8829-1073
Yixia LiNCIRE-The Veterans Health Research Institute, San Francisco, USA.
Guneet K JasujaCenter for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial VA Medical Center, Bedford, USA.
Salomeh KeyhaniSan Francisco VA Health Care System, 4150 Clement Street, 116P, San Francisco, CA, 94121, USA.
Amy L ByersSan Francisco VA Health Care System, 4150 Clement Street, 116P, San Francisco, CA, 94121, USA.
University of California, San Francisco · USEdith Nourse Rogers Memorial Veterans Hospital · USNorthern California Institute for Research and Education · USSan Francisco VA Health Care System · US

Funding

CSRD VA I01 CX001119CSRD VA IK6 CX002386HSRD VA IK2 HX002402
6 · The paper itself

Abstract

backgroundRates of suicide and unintended overdose death are high among midlife and older women, yet there is paucity of data identifying women at greatest risk. Psychoactive medications, commonly prescribed and co-prescribed in this population, may serve as salient indicators of risk for these outcomes.

objectiveTo determine whether long-term psychoactive medications and psychoactive polypharmacy predict risk of suicide and unintended overdose death among midlife and older women Veterans above and beyond other recognized factors.

designLongitudinal cohort study

participantsWomen Veterans aged ≥ 50 with at least one Veterans Health Administration (VHA) clinical encounter in FY2012-2013. MAIN MEASURES: Long-term psychoactive medications (opioids, benzodiazepines, sedative-hypnotics, antidepressants, antipsychotics, and antiepileptics, prescribed for ≥ 90/180 days) and psychoactive polypharmacy (overlapping for ≥ 1 day) from VHA pharmacy records; suicide and unintended overdose death through December 31, 2018. KEY

resultsIn this national sample of 154,558 midlife and older women Veterans (mean age 63.4, SD 9.3 years), 130 died by suicide and 175 died from unintentional overdose over an average of 5.6 years. In fully adjusted models, long-term opioids (hazard ratio (HR) 2.01, 95% CI 1.21-3.35) and benzodiazepines (HR 2.99, 95% CI 1.82-4.91) were associated with death by suicide; opioids (HR 3.62, 95% CI 2.46-5.34), benzodiazepines (HR 2.77, 95% CI 1.73-4.42), sedative-hypnotics (HR 1.87, 95% CI 1.06-3.29), antidepressants (HR 1.47, 95% CI 1.03-2.12), antipsychotics (HR 1.81, 95% CI 1.02-3.22), and antiepileptics (HR 2.17, 95% CI 1.48-3.19) were associated with unintended overdose death. Women who were co-prescribed ≥ 3 psychoactive medications had over 2-fold increased risk of suicide (HR 2.83, 95% CI 1.65-4.84) and unintended overdose death (HR 2.60, 95% CI 1.72-3.94).

conclusionsLong-term psychoactive medications and psychoactive medication polypharmacy were important indicators of risk for death by suicide and death by unintended overdose among midlife and older women Veterans, even after accounting for psychiatric and substance use disorders.

Indexed as

Antipsychotic AgentsDrug OverdoseSuicideVeteransAgedAnalgesics, OpioidAnticonvulsantsAntidepressive AgentsBenzodiazepinesFemaleHumansHypnotics and SedativesMiddle AgedPolypharmacyAnalgesics, OpioidAnticonvulsantsAntidepressive AgentsAntipsychotic AgentsBenzodiazepinesHypnotics and SedativesmortalityprescriptionssuicideVeteranswomen’s health

Identifiers

PMID36042093
PMCPMC9481785
OpenAlexW4293685763

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.