title: Antidepressant use and the risk of suicide: a population-based cohort study.
abstract: BACKGROUND
  The existing literature provides contradictory evidence on antidepressant use and risk of suicide. Some studies have shown that the use of Selective Serotonin Reuptake Inhibitors (SSRIs) is associated with an increased risk of suicide, especially during the first months of treatment, whereas other studies did not confirm this association. For this reason, our objective was to investigate the association between antidepressant use and risk of suicide in incident antidepressant users in relation to time since starting therapy.
  
  
  METHODS
  We conducted a population-based cohort study within the Dutch Integrated Primary Care Information (IPCI) database, in incident users of antidepressant therapy between 1994 and 2012 (n=27,712). Cox proportional hazard models were used to study the association between current use of SSRIs, tricyclic antidepressants (TCA) and other antidepressants and risk of suicide or attempted suicide.
  
  
  RESULTS
  During follow-up, a total of 280 incident antidepressant users attempted or committed suicide. Current use of SSRIs (hazard ratio (HR): 0.78, 95% CI: 0.57-1.07), TCAs (HR: 0.82, 95% CI: 0.48-1.42) or other antidepressants (HR: 0.75, 95% CI: 0.47-1.18) was not statistically significantly associated with suicide compared to past use of any of the antidepressants.
  
  
  CONCLUSIONS
  Although a large healthcare database was used, the number of reported cases of suicide (attempt) was low.
  
  
  CONCLUSIONS
  This study did not indicate an increase in risk of suicide after starting treatment with SSRIs, TCAs or other antidepressants compared with past antidepressant use.
authors.affiliation: Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, The Netherlands.
authors.forename: Kiki
authors.initials: K
authors.lastname: Cheung
authors.affiliation: Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus MC - University Medical Centre Rotterdam, The Netherlands.
authors.forename: Nikkie
authors.initials: N
authors.lastname: Aarts
authors.affiliation: Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, The Netherlands; Department of Internal Medicine, Erasmus MC - University Medical Centre Rotterdam, The Netherlands.
authors.forename: Raymond
authors.initials: R
authors.lastname: Noordam
authors.affiliation: Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, The Netherlands; Department of Medical Informatics, Erasmus MC - University Medical Centre Rotterdam, The Netherlands.
authors.forename: Jan C
authors.initials: JC
authors.lastname: van Blijderveen
authors.affiliation: Department of Medical Informatics, Erasmus MC - University Medical Centre Rotterdam, The Netherlands.
authors.forename: Miriam C
authors.initials: MC
authors.lastname: Sturkenboom
authors.affiliation: Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, The Netherlands.
authors.forename: Rikje
authors.initials: R
authors.lastname: Ruiter
authors.affiliation: Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, The Netherlands; Apotheek Haagse Ziekenhuizen - HAGA, The Hague, The Netherlands.
authors.forename: Loes E
authors.initials: LE
authors.lastname: Visser
authors.affiliation: Department of Epidemiology, Erasmus MC - University Medical Centre Rotterdam, The Netherlands; Inspectorate of Health Care, The Hague, The Netherlands. Electronic address: b.stricker@erasmusmc.nl.
authors.forename: Bruno H
authors.initials: BH
authors.lastname: Stricker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects*; D002648:Child; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D013997:Time Factors; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; Depression; Selective Serotonin Reuptake Inhibitors; Suicide; Tricyclic