What is the clinical evidence from this study?

Study design: Cohort. Population: Antidepressant treatment (n=65103). Intervention: Newer antidepressant drugs vs. Older antidepressant drugs. Primary outcome: Death by suicide and serious suicide attempt.

What question did this study set out to answer?

To evaluate the risk of suicide death and serious suicide attempt in relation to the initiation of antidepressant treatment.

January 1, 2006American Journal of Psychiatry

Suicide Risk During Antidepressant Treatment

Q: What does this research mean for the field?

Initiation of newer antidepressant drugs does not significantly increase the risk of suicide or serious suicide attempt, with overall cohort rates of 40 and 93 per 100,000 treatment episodes. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

View Full Paper

Ask AI

Bookmark

Key result

Initiation of newer antidepressant drugs did not significantly increase the risk of suicide or serious suicide attempt, with overall cohort rates of 40 and 93 per 100,000 treatment episodes.

Why the study?

Does antidepressant treatment increase the risk of suicide death or serious suicide attempt in patients?

Key Points

To evaluate the risk of suicide death and serious suicide attempt in relation to the initiation of antidepressant treatment.
Analyzed computerized health plan records of 65,103 patients across 82,285 antidepressant treatment episodes between Jan. 1, 1992, and June 30, 2003.
Identified deaths by suicide via state and national death certificates and serious suicide attempts requiring hospitalization using hospital discharge data over a 6-month follow-up.
In the 6 months after starting treatment, 31 suicide deaths (40 per 100,000 episodes) and 76 serious attempts (93 per 100,000 episodes) occurred, with attempt rates reaching 314 per 100,000 in children and adolescents versus 78 per 100,000 in adults.
The risk of suicide attempt peaked in the month prior to starting medication and declined progressively thereafter, with suicide death rates showing no significant increase in the first month compared to later months.
An increase in risk after treatment initiation was identified only for older antidepressants, not for the 10 newer antidepressants cited in FDA advisories.

Study Design

Type

Cohort (n=65,103)

Structured PICO

Does antidepressant treatment increase the risk of suicide death or serious suicide attempt in patients?

Population

65,103 patients with 82,285 episodes of antidepressant treatment between Jan. 1, 1992, and June 30, 2003

Intervention

Antidepressant treatment (including 10 newer antidepressants and older drugs)

Comparator

Time periods (month before vs after starting treatment) and older vs newer antidepressant drugs

Outcome

Death by suicide and serious suicide attempt (leading to hospitalization)safety

Population-based data indicate that the risk of suicide attempt is highest before starting antidepressants and declines progressively, challenging concerns that newer antidepressants acutely increase suicide risk.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Supports declining suicide risk after initiation; challenges 2004 FDA warning but should not yet change practice without RCTs.

Cite This Study

Simon et al. (2006) conducted a cohort in Antidepressant treatment (n=65,103). Newer antidepressant drugs vs. Older antidepressant drugs was evaluated on Death by suicide and serious suicide attempt. Initiation of newer antidepressant drugs did not significantly increase the risk of suicide or serious suicide attempt, with overall cohort rates of 40 and 93 per 100,000 treatment episodes.

synapsesocial.com/papers/6a192599f3c200df1057ef7a https://doi.org/10.1176/appi.ajp.163.1.41

View Full Paper

Ask AI

Bookmark