 |
|
Antidepressant Drug Therapy and Suicide in Severely Depressed Children and Adults
A Case-Control Study
Mark Olfson, MD, MPH;
Steven C. Marcus, PhD;
David Shaffer, MD
Arch Gen Psychiatry. 2006;63:865-872.
Context The Food and Drug Administration has issued a boxed warning concerning increased suicidal ideation and behavior associated with antidepressant drug treatment in children and adolescents. It is unknown whether antidepressant agents increase the risk of suicide death in children or adults.
Objective To estimate the relative risk of suicide attempt and suicide death in severely depressed children and adults treated with antidepressant drugs vs those not treated with antidepressant drugs.
Design Matched case-control study.
Setting Outpatient treatment settings in the United States.
Participants Medicaid beneficiaries from all 50 states who received inpatient treatment for depression, excluding patients treated for pregnancy, bipolar disorder, schizophrenia or other psychoses, mental retardation, dementia, or delirium. Controls were matched to cases for age, sex, race or ethnicity, state of residence, substance use disorder, recent suicide attempt, number of days since hospital discharge, and recent treatment with antipsychotic, anxiolytic/hypnotic, mood stabilizer, and stimulant medications.
Main Outcome Measures Suicide attempts and suicide deaths.
Results In adults (aged 19-64 years), antidepressant drug treatment was not significantly associated with suicide attempts (odds ratio [OR], 1.10; 95% confidence interval [CI], 0.86-1.39 [521 cases and 2394 controls]) or suicide deaths (OR, 0.90; 95% CI, 0.52-1.55 [86 cases and 396 controls]). However, in children and adolescents (aged 6-18 years), antidepressant drug treatment was significantly associated with suicide attempts (OR, 1.52; 95% CI, 1.12-2.07 [263 cases and 1241 controls]) and suicide deaths (OR, 15.62; 95% CI, 1.65-infinity [8 cases and 39 controls]).
Conclusions In these high-risk patients, antidepressant drug treatment does not seem to be related to suicide attempts and death in adults but might be related in children and adolescents. These findings support careful clinical monitoring during antidepressant drug treatment of severely depressed young people.
Author Affiliations: New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (Drs Olfson and Shaffer); and University of Pennsylvania School of Social Policy and Practice, Philadelphia (Dr Marcus).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Risk of suicidality in clinical trials of antidepressants in adults: analysis of proprietary data submitted to US Food and Drug Administration
Stone et al.
BMJ 2009;339:b2880-b2880.
ABSTRACT
| FULL TEXT
Screening for Child and Adolescent Depression in Primary Care Settings: A Systematic Evidence Review for the US Preventive Services Task Force
Williams et al.
Pediatrics 2009;123:e716-e735.
ABSTRACT
| FULL TEXT
Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies
Barbui et al.
CMAJ 2009;180:291-297.
ABSTRACT
| FULL TEXT
Efficacy of antidepressants in juvenile depression: meta-analysis
Tsapakis et al.
Br. J. Psychiatry 2008;193:10-17.
ABSTRACT
| FULL TEXT
Health advisories: when good intentions go bad
Mamdani
CMAJ 2008;178:1025-1026.
FULL TEXT
A Developmental Perspective on the Controversy Surrounding the Use of SSRIs to Treat Pediatric Depression
Leckman and King
Am. J. Psychiatry 2007;164:1304-1306.
FULL TEXT
Decline in Treatment of Pediatric Depression After FDA Advisory on Risk of Suicidality With SSRIs
Libby et al.
Am. J. Psychiatry 2007;164:884-891.
ABSTRACT
| FULL TEXT
How Can We Know Whether Antidepressants Increase Suicide Risk?
Simon
Am. J. Psychiatry 2006;163:1861-1863.
FULL TEXT
Comparing Suicide Risk with Antidepressants in Children and Adults
JWatch Psychiatry 2006;2006:1-1.
FULL TEXT
|
