@article{ref1,
title="Suicide and self-harm following prescription of SSRIs and other antidepressants: confounding by indication",
journal="British journal of clinical pharmacology",
year="2005",
author="Didham, Rebecca C. and McConnell, Doug W. and Blair, Hayden J. and Reith, D. M.",
volume="60",
number="5",
pages="519-525",
abstract="Aim: To identify the incidence and risk of suicide and self harm, among patients prescribed antidepressant drugs. Methods: A retrospective cohort study, with nested case control, of patients identified from a nonrandom sample of general practices in New Zealand from 1996 to 2001. A total of 57 361 patients who received a prescription for a single antidepressant were identified from the RNZCGP Research Unit Database. Suicides within 120 days of a prescription were identified from the New Zealand National Mortality Database and self-harm events within 120 days of a prescription were identified from the New Zealand Hospital discharge database. Results: 26 suicides and 330 episodes of self-harm were identified within 120 days of an antidepressant prescription. On univariate analysis the association, expressed as OR (95% CI), between selective serotonin reuptake inhibitors (SSRIs) and self harm and suicide were 2.26 (1.27-4.76) and 1.92 (0.77-4.83), respectively. When corrected for the confounding effects of age, gender and depression/suicidal ideation there was an association between SSRIs and self harm, OR 1.66 (95% CI 1.23-2.23), but not for suicide, 1.28 (0.38-4.35). Paroxetine was a significant risk factor for suicide on univariate analysis, 4.23 (1.19-14.95), but not when corrected for age, gender and depression/suicidal ideation, 2.76 (0.30-24.87). Conclusions: Age, gender and pre-existing depression/suicidal ideation are important confounders in observational studies of the association between antidepressants and suicide or self harm.",
language="",
issn="0306-5251",
doi="10.1111/j.1365-2125.2005.02480.x",
url="http://dx.doi.org/10.1111/j.1365-2125.2005.02480.x"
}