What does this research mean for the field?

Antidepressant treatment in adults does not significantly increase the risk of suicide attempts compared to untreated depression, and there is no significant difference in risk between SSRI and SNRI classes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine whether specific antidepressant drug classes alter the risk and time course of suicide attempts in adults with depression compared to untreated patients and the general population.

December 3, 2015The British Journal of PsychiatryOpen Access

Comparison of antidepressant classes and the risk and time course of suicide attempts in adults: propensity matched, retrospective cohort study

View Full Paper

Ask AI

Bookmark

Why the study?

Does antidepressant therapy increase the risk of suicide attempts in adults with incident depression compared to untreated depression or the general population?

Population

128,111 adults with incident depression, mean age ~41-44 years, ~65-67% female, from a US claims database.

Comparison

Antidepressant therapy initiated within 30 days… vs Untreated depression group and a matched…

Design

Cohort

Follow-up

6 months

Authors

RVRobert J. ValuckUniversity of Colorado Anschutz Medical Campus ALAnne M. LibbyUniversity of Colorado Anschutz Medical Campus HAHeather AndersonUniversity of Colorado Anschutz Medical Campus

Discussion

Member takes

Overview

No association of antidepressants with suicide attempts in incident depression; leaves open causal effects pending randomized trials.

Key Points

To determine whether specific antidepressant drug classes alter the risk and time course of suicide attempts in adults with depression compared to untreated patients and the general population.
Conducted a retrospective propensity-matched new-user cohort study comparing adults with incident depression initiating antidepressants against untreated cohorts and the general population.
Evaluated suicide attempt rates over time across selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs).
Suicide attempt rates peaked in the month prior to diagnosis in the treated group before declining steadily over the subsequent 6 months, whereas the untreated group peaked in the second month post-diagnosis.
Depression cohorts had significantly higher suicide attempt risk than the general population, but risk did not differ significantly between antidepressant-treated and untreated groups or between SSRI and SNRI classes.

Structured PICO

Does antidepressant therapy increase the risk of suicide attempts in adults with incident depression compared to untreated depression or the general population?

Population

128,111 adults (≥19 years) with incident depression (and a matched general population sample), mean age ~41-44 years, ~65-67% female, from a US claims database (IMS LifeLink).

Intervention

Antidepressant therapy (SNRI, SSRI, TCA, or multiple antidepressants) initiated within 30 days of incident depression diagnosis.

Comparator

Untreated depression group (no antidepressant therapy during the study period) and a matched community-based general population sample.

Outcome

Suicide attempt leading to a medical encounter during the 6-month follow-up period.safety

In adults with incident depression, antidepressant treatment (including SNRIs and SSRIs) was not associated with a significantly higher risk of suicide attempts compared to untreated depression.

Limitations

Completed suicides are not captured in the LifeLink database and were thus not included as an outcome measure

Cite This Study

Valuck et al. (2015) studied this question.

synapsesocial.com/papers/6a1eb9115dae381e029a82ea https://doi.org/10.1192/bjp.bp.114.150839

View Full Paper

Ask AI

Bookmark

December 3, 2015The British Journal of PsychiatryOpen Access

Comparison of antidepressant classes and the risk and time course of suicide attempts in adults: propensity matched, retrospective cohort study

View Full Paper

Ask AI

Bookmark

Why the study?

Does antidepressant therapy increase the risk of suicide attempts in adults with incident depression compared to untreated depression or the general population?

Population

128,111 adults with incident depression, mean age ~41-44 years, ~65-67% female, from a US claims database.

Comparison

Antidepressant therapy initiated within 30 days… vs Untreated depression group and a matched…

Design

Cohort

Follow-up

6 months

Authors

RVRobert J. ValuckUniversity of Colorado Anschutz Medical Campus ALAnne M. LibbyUniversity of Colorado Anschutz Medical Campus HAHeather AndersonUniversity of Colorado Anschutz Medical Campus

Discussion

Member takes

Overview

No association of antidepressants with suicide attempts in incident depression; leaves open causal effects pending randomized trials.

Key Points

To determine whether specific antidepressant drug classes alter the risk and time course of suicide attempts in adults with depression compared to untreated patients and the general population.
Conducted a retrospective propensity-matched new-user cohort study comparing adults with incident depression initiating antidepressants against untreated cohorts and the general population.
Evaluated suicide attempt rates over time across selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs).
Suicide attempt rates peaked in the month prior to diagnosis in the treated group before declining steadily over the subsequent 6 months, whereas the untreated group peaked in the second month post-diagnosis.
Depression cohorts had significantly higher suicide attempt risk than the general population, but risk did not differ significantly between antidepressant-treated and untreated groups or between SSRI and SNRI classes.

Structured PICO

Does antidepressant therapy increase the risk of suicide attempts in adults with incident depression compared to untreated depression or the general population?

Population

128,111 adults (≥19 years) with incident depression (and a matched general population sample), mean age ~41-44 years, ~65-67% female, from a US claims database (IMS LifeLink).

Intervention

Antidepressant therapy (SNRI, SSRI, TCA, or multiple antidepressants) initiated within 30 days of incident depression diagnosis.

Comparator

Untreated depression group (no antidepressant therapy during the study period) and a matched community-based general population sample.

Outcome

Suicide attempt leading to a medical encounter during the 6-month follow-up period.safety

In adults with incident depression, antidepressant treatment (including SNRIs and SSRIs) was not associated with a significantly higher risk of suicide attempts compared to untreated depression.

Limitations

Completed suicides are not captured in the LifeLink database and were thus not included as an outcome measure

Cite This Study

Valuck et al. (2015) studied this question.

synapsesocial.com/papers/6a1eb9115dae381e029a82ea https://doi.org/10.1192/bjp.bp.114.150839

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

View Full Paper

Ask AI

Bookmark