Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

Clinton's and Trump's appeal to voters viewed from perspective of Neidert and Lesthaeghe's SDT framework

Stephenson assessing in-home HIV testing and counseling for male couples

Thompson says mass incarceration causes collapse of Detroit neighborhoods

Highlights

Maggie Levenstein named director of ISR's Inter-university Consortium for Political and Social Research

Arline Geronimus receives 2016 Harold R. Johnson Diversity Service Award

PSC spring 2016 newsletter: Kristin Seefeldt, Brady West, newly funded projects, ISR Runs for Bob, and more

AAUP reports on faculty compensation by category, affiliation, and academic rank

Next Brown Bag

PSC Brown Bags
will resume fall 2016

Antidepressant agents and suicide death among US Department of Veterans Affairs patients in depression treatment

Publication Abstract

Valenstein, M., Hyungjin Myra Kim, D. Ganoczy, Daniel Eisenberg, P. Pfeiffer, K. Downing, K. Hoggatt, M. Ilgen, K. Austin, Kara Zivin, F. Blow, and J. McCarthy. 2012. "Antidepressant agents and suicide death among US Department of Veterans Affairs patients in depression treatment." Journal of Clinical Psychopharmacology, 32(3): 346-53.

BACKGROUND: Studies report mixed findings regarding antidepressant agents and suicide risks, and few examine suicide deaths. Studies using observational data can accrue the large sample sizes needed to examine suicide death, but selection biases must be addressed. We assessed associations between suicide death and treatment with the 7 most commonly used antidepressants in a national sample of Department of Veterans Affairs patients in depression treatment. Multiple analytic strategies were used to address potential selection biases. METHODS: We identified Department of Veterans Affairs patients with depression diagnoses and new antidepressant starts between April 1, 1999, and September 30, 2004 (N = 502,179). Conventional Cox regression models, Cox models with inverse probability of treatment weighting, propensity-stratified Cox models, marginal structural models (MSM), and instrumental variable analyses were used to examine relationships between suicide and exposure to bupropion, citalopram, fluoxetine, mirtazapine, paroxetine, sertraline, and venlafaxine. RESULTS: Crude suicide rates varied from 88 to 247 per 100,000 person-years across antidepressant agents. In multiple Cox models and MSMs, sertraline and fluoxetine had lower risks for suicide death than paroxetine. Bupropion had lower risks than several antidepressants in Cox models but not MSMs. Instrumental variable analyses did not find significant differences across antidepressants. DISCUSSION: Most antidepressants did not differ in their risk for suicide death. However, across several analytic approaches, although not instrumental variable analyses, fluoxetine and sertraline had lower risks of suicide death than paroxetine. These findings are congruent with the Food and Drug Administration meta-analysis of randomized controlled trials reporting lower risks for "suicidality" for sertraline and a trend toward lower risks with fluoxetine than for other antidepressants. Nevertheless, divergence in findings by analytic approach suggests caution when interpreting results.

DOI:10.1097/JCP.0b013e3182539f11 (Full Text)

PMCID: PMC3517726. (Pub Med Central)

Browse | Search : All Pubs | Next