Epidemiologic study of aripiprazole use and the incidence of suicide events

Yood, Marianne Ulcickas; DeLorenze, Gerald N.; Quesenberry, Charles P.; Tsai, Ai‐Lin; Phillips, Syd; Willey, Vincent J.; Niemcryk, Steve J.; Wells, Karen; Skovron, Mary Lou; Cziraky, Mark J.; Carson, William H.; Oliveria, Susan A.

doi:10.1002/pds.2047

Cited by 19 publications

(8 citation statements)

References 12 publications

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“…The difficulty of evaluating suicidal risk more explicitly is illustrated by several trials in which suicidal behaviors were rarely encountered among subjects randomized either to ziprasidone (in doses up to 160 mg/day) or to a placebo [14,78,79,80]. Ziprasidone was included among other atypical antipsychotics in a case-control study of 4000 psychotic disorder patients in Sweden, in which treatment with atypical antipsychotic drugs (including clozapine, olanzapine, and risperidone as well as ziprasidone) yielded fewer completed suicides than alternative treatments.…”

Section: Resultsmentioning

confidence: 99%

“…However, aripiprazole has also been associated with excessive arousal, anxiety, and akathisia, which might increase suicidal risk, as has been suggested in case reports [82,83]. However, a review of clinical observations in a total of 20,489 psychotic disorder patients found rates of suicidal events associated with aripiprazole [22] to be somewhat lower than with quetiapine [33] or ziprasidone (49 per 1000 person-years), with a not significantly different overall rate of such events compared with other antipsychotics after adjustment for the effects of diagnosis, illness severity, and other treatments (HR = 0.78 [CI: 0.48–1.30]) [80]. …”

Section: Resultsmentioning

confidence: 99%

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Do Atypical Antipsychotics Have Antisuicidal Effects? A Hypothesis-Generating Overview

Pompili

Baldessarini

Forte

et al. 2016

IJMS

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Modern antipsychotic drugs are employed increasingly in the treatment of mood disorders as well as psychoses, stimulating interest in their possible contributions to altering suicidal risk. Clozapine remains the only treatment with an FDA-recognized indication for reducing suicidal risk (in schizophrenia). We carried out a systematic, computerized search for reports of studies involving antipsychotic drug treatment and suicidal behaviors. A total of 19 reports provide data with preliminary support for potential suicide risk-reducing effects of olanzapine, quetiapine, ziprasidone, aripiprazole, and asenapine in addition to clozapine, and provide some support for antipsychotic drug treatment in general. These preliminary findings encourage further testing of antipsychotics for effects on suicidal behavior, making use of explicit, pre-planned assessments of suicidal behavior.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Do Atypical Antipsychotics Have Antisuicidal Effects? A Hypothesis-Generating Overview

Pompili

Baldessarini

Forte

et al. 2016

IJMS

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show abstract

“…These plans include health maintenance, point-of-service, preferred provider organizations, and indemnity plans located across the Northeastern, Southeastern, mid-Atlantic, Midwestern, and Western regions. The HIRD has been used previously in multiple incidence cost studies [15]–[18].…”

Section: Methodsmentioning

confidence: 99%

Skin and Soft Tissue Infections and Associated Complications among Commercially Insured Patients Aged 0–64 Years with and without Diabetes in the U.S.

et al. 2013

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IntroductionSkin and soft tissue infections (SSTIs) are common infections occurring in ambulatory and inpatient settings. The extent of complications associated with these infections by diabetes status is not well established.MethodsUsing a very large repository database, we examined medical and pharmacy claims of individuals aged 0–64 between 2005 and 2010 enrolled in U.S. health plans. Diabetes, SSTIs, and SSTI-associated complications were identified by ICD-9 codes. SSTIs were stratified by clinical category and setting of initial diagnosis.ResultsWe identified 2,227,401 SSTI episodes, 10% of which occurred in diabetic individuals. Most SSTIs were initially diagnosed in ambulatory settings independent from diabetes status. Abscess/cellulitis was the more common SSTI group in diabetic and non-diabetic individuals (66% and 59%, respectively). There were differences in the frequencies of SSTI categories between diabetic and non-diabetic individuals (p<0.01). Among SSTIs diagnosed in ambulatory settings, the SSTI-associated complication rate was over five times higher in people with diabetes than in people without diabetes (4.9% vs. 0.8%, p<0.01) and SSTI-associated hospitalizations were 4.9% and 1.1% in patients with and without diabetes, respectively. Among SSTIs diagnosed in the inpatient setting, bacteremia/endocarditis/septicemia/sepsis was the most common associated complication occurring in 25% and 16% of SSTIs in patients with and without diabetes, respectively (p<0.01).ConclusionsAmong persons with SSTIs, we found SSTI-associated complications were five times higher and SSTI-associated hospitalizations were four times higher, in patients with diabetes compared to those without diabetes. SSTI prevention efforts in individuals with diabetes may have significant impact on morbidity and healthcare resource utilization.

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“…In a large post marketing study of aripiprazole, Ulcickas et al. found that aripiprazole used for schizophrenia and bipolar disorder was not associated with increased suicidality compared to a combined group of other antipsychotics. The unadjusted rate of suicide attempts plus completion was 2.069 events per 100 patient‐years as compared to 2.399 for olanzapine, 3.233 for quetiapine, 1.969 for risperidone, and 4.852 for ziprasidone .…”

Section: Antipsychoticsmentioning

confidence: 99%

Impact of psychotropic drugs on suicide and suicidal behaviors

Yerevanian

Choi

2013

Bipolar Disorders

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The available evidence for the impact of psychotropics on suicidal risk in patients with bipolar disorder is largely methodologically flawed and, except for a few instances, clinically not useful at this point. Adequately powered, prospective randomized controlled studies are needed to assess the impact of each class of psychotropic and each psychotropic as well as common combination therapies. Until such studies have been carried out, clinicians are urged to exercise caution in using these drugs and rely on the traditional means of carefully assessing and monitoring patients with bipolar disorder who are at high risk for suicide.

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Epidemiologic study of aripiprazole use and the incidence of suicide events

Abstract: In this large, multi-site study, compared with other SGA combined, aripiprazole is not associated with an increased risk of suicide events in an inception cohort of patients with ICD-9/ICD-10 codes indicative of schizophrenia or bipolar disorder.

Cited by 19 publications

References 12 publications

Do Atypical Antipsychotics Have Antisuicidal Effects? A Hypothesis-Generating Overview

Do Atypical Antipsychotics Have Antisuicidal Effects? A Hypothesis-Generating Overview

Skin and Soft Tissue Infections and Associated Complications among Commercially Insured Patients Aged 0–64 Years with and without Diabetes in the U.S.

Impact of psychotropic drugs on suicide and suicidal behaviors

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