Selective serotonin reuptake inhibitors and suicidal behaviour: a population-based cohort study

Abstract

There is concern that selective serotonin reuptake inhibitor (SSRI) treatment may increase the risk of suicide attempts or deaths, particularly among children and adolescents. However, debate remains regarding the nature of the relationship. Using nationwide Swedish registers, we identified all individuals aged 6–59 years with an incident SSRI dispensation (N = 538,577) from 2006 to 2013. To account for selection into treatment, we used a within-individual design to compare the risk of suicide attempts or deaths (suicidal behaviour) in time periods before and after SSRI-treatment initiation. Within-individual incidence rate ratios (IRRs) of suicidal behaviour were estimated. The 30 days before SSRI-treatment initiation was associated with the highest risk of suicidal behaviour compared with the 30 days 1 year before SSRI initiation (IRR = 7.35, 95% CI 6.60–8.18). Compared with the 30 days before SSRI initiation, treatment periods after initiation had a reduced risk—the IRR in the 30 days after initiation was 0.62 (95% CI 0.58–0.65). The risk then declined over treatment time. These patterns were similar across age strata, and when stratifying on history of suicide attempts. Initiation with escitalopram was associated with the greatest risk reduction, though CIs for the IRRs of the different SSRI types were overlapping. The results do not suggest that SSRI-treatment increases the risk for suicidal behaviour in either youths or adults; rather, it may reduce the risk. Further research with different study designs and in different populations is warranted.

Epidemiology of suicide and suicide attempts in Jahrom district, Southern Iran in light of COVID pandemic: A prospective observational study

“…46 Many studies have been conducted on the effect of antidepressants in treating depression and preventing suicide, and completely different results have been extracted. Some studies have reported a positive effect, [47][48][49] and others have said an adverse effect or lack of effectiveness of these drugs. [50][51][52] One of the reasons for the non-use of antidepressants by the participants may be the belief that these drugs cause dependence and addiction and should be taken for a lifetime.…”

Genotyping of patients treated with selective serotonin reuptake inhibitors

“…Seksuell dysfunksjon er vanlig hos både kvinner og menn (4), og høye doser citalopram og escitalopram er kontraindisert grunnet fare for arytmier (5). Det er også bekymring for en initial økning i selvmordsforsøk (3), selv om noen studier indikerer det motsa e (6).…”

Pharmakotherapie bei Angststörungen – eine kritische Auseinandersetzung

“…Ein besonderes Augenmerk muss auf die Diskussion bezüglich eines möglicherweise erhöhten Suizidrisikos unter der Einnahme von SSRI gelegt werden. Neuere Studien und Metaanalysen weisen insgesamt nicht eindeutig auf ein erhöhtes Suizidrisiko hin [15], jedoch ist weiterhin unbedingt eine Aufklärung über diesen Umstand sowie die Besprechung eines Notfallplans mit Patienten notwendig.…”