title: Comparison of antidepressant classes and the risk and time course of suicide attempts in adults: propensity matched, retrospective cohort study.
abstract: BACKGROUND
  Placebo-controlled clinical trials have led to concern over possible increased risk of suicide-related events in some populations exposed to antidepressants.
  
  
  OBJECTIVE
  To evaluate the risk of suicide attempts by antidepressant drug class and the presence or absence of depression.
  
  
  METHODS
  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).
authors.affiliation: Robert J. Valuck, PhD, RPh, FNAP, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Anne M. Libby, PhD, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; Heather D. Anderson, PhD, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Richard R. Allen, MS, Peak Statistical Services, Evergreen, Colorado, USA; Indiana Strombom, PhD, Genentech, San Francisco, California, USA; Lauren B. Marangell, MD, Department of Psychiatry, University of Texas Health Science Center, Houston, Texas, and Brain Health Consultants, Houston, Texas, USA; David Perahia, MBBS, BSc, MRCPsych, Eli Lilly and Company, Erl Wood, Windlesham, UK.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Valuck
authors.affiliation: Robert J. Valuck, PhD, RPh, FNAP, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Anne M. Libby, PhD, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; Heather D. Anderson, PhD, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Richard R. Allen, MS, Peak Statistical Services, Evergreen, Colorado, USA; Indiana Strombom, PhD, Genentech, San Francisco, California, USA; Lauren B. Marangell, MD, Department of Psychiatry, University of Texas Health Science Center, Houston, Texas, and Brain Health Consultants, Houston, Texas, USA; David Perahia, MBBS, BSc, MRCPsych, Eli Lilly and Company, Erl Wood, Windlesham, UK.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Libby
authors.affiliation: Robert J. Valuck, PhD, RPh, FNAP, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Anne M. Libby, PhD, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; Heather D. Anderson, PhD, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Richard R. Allen, MS, Peak Statistical Services, Evergreen, Colorado, USA; Indiana Strombom, PhD, Genentech, San Francisco, California, USA; Lauren B. Marangell, MD, Department of Psychiatry, University of Texas Health Science Center, Houston, Texas, and Brain Health Consultants, Houston, Texas, USA; David Perahia, MBBS, BSc, MRCPsych, Eli Lilly and Company, Erl Wood, Windlesham, UK.
authors.forename: Heather D
authors.initials: HD
authors.lastname: Anderson
authors.affiliation: Robert J. Valuck, PhD, RPh, FNAP, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Anne M. Libby, PhD, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; Heather D. Anderson, PhD, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Richard R. Allen, MS, Peak Statistical Services, Evergreen, Colorado, USA; Indiana Strombom, PhD, Genentech, San Francisco, California, USA; Lauren B. Marangell, MD, Department of Psychiatry, University of Texas Health Science Center, Houston, Texas, and Brain Health Consultants, Houston, Texas, USA; David Perahia, MBBS, BSc, MRCPsych, Eli Lilly and Company, Erl Wood, Windlesham, UK.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Allen
authors.affiliation: Robert J. Valuck, PhD, RPh, FNAP, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Anne M. Libby, PhD, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; Heather D. Anderson, PhD, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Richard R. Allen, MS, Peak Statistical Services, Evergreen, Colorado, USA; Indiana Strombom, PhD, Genentech, San Francisco, California, USA; Lauren B. Marangell, MD, Department of Psychiatry, University of Texas Health Science Center, Houston, Texas, and Brain Health Consultants, Houston, Texas, USA; David Perahia, MBBS, BSc, MRCPsych, Eli Lilly and Company, Erl Wood, Windlesham, UK.
authors.forename: Indiana
authors.initials: I
authors.lastname: Strombom
authors.affiliation: Robert J. Valuck, PhD, RPh, FNAP, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Anne M. Libby, PhD, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; Heather D. Anderson, PhD, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Richard R. Allen, MS, Peak Statistical Services, Evergreen, Colorado, USA; Indiana Strombom, PhD, Genentech, San Francisco, California, USA; Lauren B. Marangell, MD, Department of Psychiatry, University of Texas Health Science Center, Houston, Texas, and Brain Health Consultants, Houston, Texas, USA; David Perahia, MBBS, BSc, MRCPsych, Eli Lilly and Company, Erl Wood, Windlesham, UK.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Marangell
authors.affiliation: Robert J. Valuck, PhD, RPh, FNAP, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Anne M. Libby, PhD, Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA; Heather D. Anderson, PhD, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA; Richard R. Allen, MS, Peak Statistical Services, Evergreen, Colorado, USA; Indiana Strombom, PhD, Genentech, San Francisco, California, USA; Lauren B. Marangell, MD, Department of Psychiatry, University of Texas Health Science Center, Houston, Texas, and Brain Health Consultants, Houston, Texas, USA; David Perahia, MBBS, BSc, MRCPsych, Eli Lilly and Company, Erl Wood, Windlesham, UK perahia_david_g@lilly.com.
authors.forename: David
authors.initials: D
authors.lastname: Perahia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000145:classification*; D015283:Citalopram / Q000627:therapeutic use; D015897:Comorbidity; D016208:Databases, Factual; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D015283:Citalopram; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors