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A study of the relation of exposure to quinolones and suicidal behaviour
S S Jick1, C Vasilakis, C Martinez
1The Boston Collaborative Drug Surveillance Program, Boston University Medical Center, Lexington, MA 02173, USA.
Aims:
To investigate the concern, raised by spontaneous reports received by the German regulatory authorities, that use of quinolone antibiotics may increase the risk for suicide and other suicidal behaviours.
Methods:
We carried out a nested case-control study using the General Practice Research Database (GPRD). We compared the risk of suicidal behaviours among users of quinolones, other antibiotics and no antibiotics.
Results:
From January 1, 1991 through April 30, 1995 we identified 348 cases of suicide, attempted suicide, or suicidal ideation and 808 controls. Compared with controls, cases who had received a prescription for a quinolone in the 30 days prior to the event had an adjusted relative risk (RR) estimate of 1.5 (95% CI 0.4-6.3) for any suicidal behaviour. Cases who had filled a prescription for a quinolone in the 31 to 180 days prior to their event had an adjusted RR estimate of 0.8 (95% CI 0.4-1.7) compared with controls. Cases who used other antibiotics in the 30 days prior to the event conferred an adjusted RR estimate of 1.1 (95% CI 0.6-2.2), and 0.9 (95% CI 0.6-1.3) for exposure in the 31 to 180 days prior to the event. The results were not materially different when suicide, suicide attempt, and suicidal ideation were analyzed separately.
Conclusions:
We conclude that there is no material increased risk of suicidal behaviours for use of quinolone antibiotics compared with non-use or use of other antibiotics.