Format

Send to

Choose Destination
Br J Clin Pharmacol. 2005 Nov;60(5):519-25.

Suicide and self-harm following prescription of SSRIs and other antidepressants: confounding by indication.

Author information

1
Research Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

Abstract

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.

PMID:
16236042
PMCID:
PMC1884935
DOI:
10.1111/j.1365-2125.2005.02480.x
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center