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

  • Robert J. Valuck (a1), Anne M. Libby (a2), Heather D. Anderson (a1), Richard R. Allen (a3), Indiana Strombom (a4), Lauren B. Marangell (a5) and David Perahia (a6)...

Abstract

Background

Placebo-controlled clinical trials have led to concern over possible increased risk of suicide-related events in some populations exposed to antidepressants.

Aims

To evaluate the risk of suicide attempts by antidepressant drug class and the presence or absence of depression.

Method

A retrospective propensity-matched new-user cohort study was used to compare participants with incident depression classified by antidepressant treatment with each other and with the general population.

Results

Among the treated group, the suicide attempt rate peaked in the month prior to diagnosis then decreased steadily over the next 6 months. Among the pharmacologically untreated group, the highest rate was seen in the second month after diagnosis. Cohorts with depression had significantly higher suicide attempt risk than the general population, but the treated group did not differ significantly from the untreated group.

Conclusions

Patients on antidepressants did not have significantly higher risk compared with untreated patients. No significant differences were observed for patients treated with individual serotonin–noradrenaline reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs) or by class (SSRI v. SNRI cohorts).

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Copyright

Corresponding author

Correspondence: Dr David G. S. Perahia, Lilly Research Centre, Erl Wood, Sunninghill Road, Windlesham, Surrey GU20 6PH, UK. Email: perahia_david_g@lilly.com

Footnotes

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This study was funded by Eli Lilly and Company, Indianapolis, per a regulatory study request by the European Medicines Agency (EMA).

Declaration of interest

R.J.V. has received research grants from Eli Lilly and Company. D.P., I.S. and L.B.M. were employees of Eli Lilly and Company at the time this research was conducted.

Footnotes

References

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

  • Robert J. Valuck (a1), Anne M. Libby (a2), Heather D. Anderson (a1), Richard R. Allen (a3), Indiana Strombom (a4), Lauren B. Marangell (a5) and David Perahia (a6)...
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eLetters

SNRI vs SSRI

HARISH CHANDRA REDDY, Psychiatrist, Indo US Hospital
05 January 2016

The article mentions there is no significant difference between SSRI and SNRI with regards to suicide attempts. Although, the two major groups and most commonly prescribed have been compared. The NaSSA group of drugs like Mirtazapine need to compared along with the aforementioned groups as the response rates for the elderly patients with suicidal risk comes down significantly with Mirtazapine seen in clinical setup. The need to compare and take forward this study by comparing with the new group of SPARI, Vilazodone would also be essential. ... More

Conflict of interest: None Declared

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