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Antidepressants and suicide

S S Jick1, A D Dean, H Jick

  • 1Boston Collaborative Drug Surveillance Program, Boston University Medical Center, Lexington, MA 02173.

BMJ (Clinical Research Ed.)
|January 28, 1995
PubMed
Summary
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This study found that after accounting for risk factors, the suicide risk was similar across 10 common antidepressants. Overdose accounted for only 14% of antidepressant-related suicides.

Area of Science:

  • Pharmacovigilance
  • Epidemiology
  • Psychiatry

Background:

  • Antidepressant medications are widely prescribed for mental health conditions.
  • Understanding the association between antidepressant use and suicide risk is crucial for patient safety.
  • Previous studies have yielded conflicting results regarding suicide risk with specific antidepressants.

Purpose of the Study:

  • To estimate the incidence and identify factors associated with suicide among individuals prescribed 10 common antidepressant drugs.
  • To compare suicide rates across different antidepressants, controlling for confounding variables.

Main Methods:

  • An open cohort study with a nested case-control analysis was conducted.
  • Data from 172,598 individuals prescribed 10 antidepressants (dothiepin, amitriptyline, clomipramine, imipramine, flupenthixol, lofepramine, mianserin, fluoxetine, doxepin, trazodone) between 1988 and 1993 in UK general practices were analyzed.

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  • Suicide was confirmed through general practitioner records or death certificates.

    • Main Results:

    • The overall suicide rate was 8.5 per 10,000 person-years.
    • Higher suicide rates were observed in men, individuals with a history of suicidal ideation, and those prescribed multiple antidepressants.
    • Increased risk was also associated with high antidepressant doses and recent prescriptions (within 30 days).

    Conclusions:

    • Several factors, including patient history and prescription patterns, are correlated with suicide risk in antidepressant users.
    • After adjusting for these factors, the risk of suicide was comparable across the 10 studied antidepressants.
    • Antidepressant overdose represented a small proportion (14%) of the suicides observed in this cohort.