title: Antidepressant use and work-related injuries.
abstract: BACKGROUND
  Adverse effects of antidepressants are most common at the beginning of the treatment, but possible also later. We examined the association between antidepressant use and work-related injuries taking into account the duration of antidepressant use.
  
  
  METHODS
  Antidepressant use and work-related injuries between 2000 and 2011 were measured among 66 238 employees (mean age 43.8 years, 80% female) using linkage to national records (the Finnish Public Sector study). We analysed data using time-dependent modelling with individuals as their own controls (self-controlled case-series design).
  
  
  RESULTS
  In 2238 individuals who had used antidepressants and had a work-related injury during a mean follow-up of 7.8 years, no increase in the risk of injury was observed in the beginning of antidepressant treatment. However, an increased injury risk was seen after 3 months of treatment (rate ratio, compared with no recent antidepressant use, 1.27, 95% confidence interval 1.10-1.48). This was also the case among those who had used only selective serotonin reuptake inhibitors (n = 714; rate ratio 1.41, 95% confidence interval 1.08-1.83).
  
  
  CONCLUSIONS
  Antidepressant use was not associated with an increased risk of work-related injury at the beginning of treatment. Post-hoc analyses of antidepressant trials are needed to determine whether long-term use of antidepressants increases the risk of work-related injury.
authors.affiliation: Department of Social Research,University of Helsinki,Helsinki,Finland.
authors.forename: A
authors.initials: A
authors.lastname: Kouvonen
authors.affiliation: Finnish Institute of Occupational Health,Turku and Helsinki,Finland.
authors.forename: J
authors.initials: J
authors.lastname: Vahtera
authors.affiliation: Finnish Institute of Occupational Health,Turku and Helsinki,Finland.
authors.forename: J
authors.initials: J
authors.lastname: Pentti
authors.affiliation: Department of Pharmacology, Drug Development and Therapeutics,University of Turku,Turku,Finland.
authors.forename: M J
authors.initials: MJ
authors.lastname: Korhonen
authors.affiliation: Finnish Institute of Occupational Health,Turku and Helsinki,Finland.
authors.forename: T
authors.initials: T
authors.lastname: Oksanen
authors.affiliation: Finnish Institute of Occupational Health,Turku and Helsinki,Finland.
authors.forename: P
authors.initials: P
authors.lastname: Salo
authors.affiliation: Finnish Institute of Occupational Health,Turku and Helsinki,Finland.
authors.forename: M
authors.initials: M
authors.lastname: Virtanen
authors.affiliation: Finnish Institute of Occupational Health,Turku and Helsinki,Finland.
authors.forename: M
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060051:Occupational Injuries / Q000453:epidemiology*; D012306:Risk; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Antidepressants; commuting injuries; occupational injuries; public sector; work-related injuries; workplace