期刊
SUICIDE AND LIFE-THREATENING BEHAVIOR
卷 52, 期 1, 页码 121-131出版社
WILEY
DOI: 10.1111/sltb.12812
关键词
adults; antidepressants; population study; suicidal behavior; suicide attempt
资金
- beyondblue and the National Health & Medical Research Council [APP1150655]
For Australian older adults, all antidepressants showed an elevated IRR for suicide attempt across various exposure periods, decreasing from 7.44 during the first 30 days to 2.21 at 91+ days. The four antidepressant sub-groups had higher IRRs during the first 30 days exposure. SSRIs and SNRIs still had increased IRRs during the 61- to 90-day exposure period.
Introduction Meta-analyses show antidepressant initiation has increased risk of suicidal behavior <25 years, no difference 25-64 years and reduced risk 65+ years. Estimating risks from RCTs has limitations and real-world population estimates are uncommon. Methods A self-controlled case series reporting incidence rate ratio (IRR) between exposed and control periods for antidepressants associated with suicide attempt, in Australian older age adults. We included all cases with suicide attempt [hospital data for ICD codes (X60-X84)] and any antidepressant use (n = 689) by participants in the 45 and Up Study. Results For all antidepressants the IRR for suicide attempt was elevated across all exposures, declining from 7.44 (95%CI 5.57-9.94) during the first 30 days, to 2.21 (1.73-2.81) at 91+ days. All four antidepressant sub-groups had higher IRRs for the first 30 day exposure: 2.43 (1.37-4.29) for TCAs, 4.06 (2.78-5.93) for SSRIs, 4.15 (2.65-6.50) for other antidepressants, and 4.92 (3.30-7.34) for SNRIs. Increased IRR persisted for 61- to 90-day exposures for SSRIs 2.42 (1.18-4.98) and SNRIs 2.66 (1.34-5.27). Conclusion Some older adults have increased risk of suicide attempt with antidepressant exposure, which may persist for months. Clinical guidelines should recommend a period of monitoring for treatment-emergent suicidal thoughts and behaviors in older adult patients.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据