AIM: To identify the incidence and risk of suicide and self harm, among patients prescribed antidepressant drugs. METHODS: A retrospective cohort study, with nested case control, of patients identified from a nonrandom sample of general practices in New Zealand from 1996 to 2001. A total of 57 361 patients who received a prescription for a single antidepressant were identified from the RNZCGP Research Unit Database. Suicides within 120 days of a prescription were identified from the New Zealand National Mortality Database and self-harm events within 120 days of a prescription were identified from the New Zealand Hospital discharge database. RESULTS: 26 suicides and 330 episodes of self-harm were identified within 120 days of an antidepressant prescription. On univariate analysis the association, expressed as OR (95% CI), between selective serotonin reuptake inhibitors (SSRIs) and self harm and suicide were 2.26 (1.27-4.76) and 1.92 (0.77-4.83), respectively. When corrected for the confounding effects of age, gender and depression/suicidal ideation there was an association between SSRIs and self harm, OR 1.66 (95% CI 1.23-2.23), but not for suicide, 1.28 (0.38-4.35). Paroxetine was a significant risk factor for suicide on univariate analysis, 4.23 (1.19-14.95), but not when corrected for age, gender and depression/suicidal ideation, 2.76 (0.30-24.87). CONCLUSIONS: Age, gender and pre-existing depression/suicidal ideation are important confounders in observational studies of the association between antidepressants and suicide or self harm.
AIM: To identify the incidence and risk of suicide and self harm, among patients prescribed antidepressant drugs. METHODS: A retrospective cohort study, with nested case control, of patients identified from a nonrandom sample of general practices in New Zealand from 1996 to 2001. A total of 57 361 patients who received a prescription for a single antidepressant were identified from the RNZCGP Research Unit Database. Suicides within 120 days of a prescription were identified from the New Zealand National Mortality Database and self-harm events within 120 days of a prescription were identified from the New Zealand Hospital discharge database. RESULTS: 26 suicides and 330 episodes of self-harm were identified within 120 days of an antidepressant prescription. On univariate analysis the association, expressed as OR (95% CI), between selective serotonin reuptake inhibitors (SSRIs) and self harm and suicide were 2.26 (1.27-4.76) and 1.92 (0.77-4.83), respectively. When corrected for the confounding effects of age, gender and depression/suicidal ideation there was an association between SSRIs and self harm, OR 1.66 (95% CI 1.23-2.23), but not for suicide, 1.28 (0.38-4.35). Paroxetine was a significant risk factor for suicide on univariate analysis, 4.23 (1.19-14.95), but not when corrected for age, gender and depression/suicidal ideation, 2.76 (0.30-24.87). CONCLUSIONS: Age, gender and pre-existing depression/suicidal ideation are important confounders in observational studies of the association between antidepressants and suicide or self harm.
Authors: S Donovan; A Clayton; M Beeharry; S Jones; C Kirk; K Waters; D Gardner; J Faulding; R Madeley Journal: Br J Psychiatry Date: 2000-12 Impact factor: 9.319
Authors: Jari Haukka; Martti Arffman; Timo Partonen; Sinikka Sihvo; Marko Elovainio; Jari Tiihonen; Jouko Lönnqvist; Ilmo Keskimäki Journal: Eur J Clin Pharmacol Date: 2009-03-05 Impact factor: 2.953
Authors: Sebastian Schneeweiss; Amanda R Patrick; Daniel H Solomon; Colin R Dormuth; Matt Miller; Jyotsna Mehta; Jennifer C Lee; Philip S Wang Journal: Pediatrics Date: 2010-04-12 Impact factor: 7.124