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No apparent difference in suicide risk between older and newer antidepressants although older drugs may increase risk of suicide attempt during the first month of treatment

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Q Is suicide risk related to antidepressant type (newer or older antidepressant) or greater in the first month after treatment initiation?

METHODS

Embedded ImageDesign:

Retrospective cohort study.

Embedded ImageFollow up period:

6 months following initial antidepressant prescription.

Embedded ImageSetting:

Members of a prepaid health plan in Washington and Idaho, USA.

Embedded ImagePeople:

65 203 people starting a new episode of antidepressant treatment between January 1992 and June 2003.

Embedded ImageRisk factors:

Treatment with a newer antidepressant (bupropion, citalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, escitalopram, venlafaxine) or older antidepressant (primarily tricyclic antidepressants (76%) and trazodone (21%)).

Embedded ImageOutcomes:

Suicide attempt requiring hospitalisation (verified through hospital discharge records) or death by suicide (verified through death certificate).

MAIN RESULTS

The newer antidepressants did not increase risk of suicide attempt or suicide death …

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