Universität zu Köln

Braun, Cora, Bschor, Tom, Franklin, Jeremy ORCID: 0000-0003-1536-0925 and Baethge, Christopher (2016). Suicides and Suicide Attempts during Long-Term Treatment with Antidepressants: A Meta-Analysis of 29 Placebo-Controlled Studies including 6,934 Patients with Major Depressive Disorder. Psychother. Psychosom., 85 (3). S. 171 - 180. BASEL: KARGER. ISSN 1423-0348

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Abstract

Background: It is unclear whether antidepressants can prevent suicides or suicide attempts, particularly during longterm use. Methods: We carried out a comprehensive review of long-term studies of antidepressants (relapse prevention). Sources were obtained from 5 review articles and by searches of MEDLINE, PubMed Central and a hand search of bibliographies. We meta -analyzed placebo -controlled antidepressant RCTs of at least 3 months' duration and calculated suicide and suicide attempt incidence rates, incidence rate ratios and Peto odds ratios (ORs). Results: Out of 807 studies screened 29 were included, covering 6,934 patients (5,529 patient -years). In total, 1.45 suicides and 2.76 suicide attempts per 1,000 patient -years were reported. Seven out of 8 suicides and 13 out of 14 suicide attempts occurred in antidepressant arms, resulting in incidence rate ratios of 5.03 (0.78-114.1; p = 0.102) for suicides and of 9.02 (1.58-193.6; p = 0.007) for suicide attempts. Peto ORs were 2.6 (0.6-11.2; nonsignificant) and 3.4 (1.1-11.0; p = 0.04), respectively. Dropouts due to unknown reasons were similar in the anti- depressant and placebo arms (9.6 vs. 9.9%). The majority of suicides and suicide attempts originated from 1 study, accounting for a fifth of all patient -years in this meta -analysis. Leaving out this study resulted in a nonsignificant incidence rate ratio for suicide attempts of 3.83 (0.53-91.01). Conclusions: Therapists should be aware of the lack of proof from RCTs that antidepressants prevent suicides and suicide attempts. We cannot conclude with certainty whether antidepressants increase the risk for suicide or suicide attempts. Researchers must report all suicides and suicide attempts in RCTs. (C) 2016 S. Karger AG, Basel

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Braun, Cora UNSPECIFIED UNSPECIFIED UNSPECIFIED Bschor, Tom UNSPECIFIED UNSPECIFIED UNSPECIFIED Franklin, Jeremy UNSPECIFIED orcid.org/0000-0003-1536-0925 UNSPECIFIED Baethge, Christopher UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-290255
DOI:	10.1159/000442293
Journal or Publication Title:	Psychother. Psychosom.
Volume:	85
Number:	3
Page Range:	S. 171 - 180
Date:	2016
Publisher:	KARGER
Place of Publication:	BASEL
ISSN:	1423-0348
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SEROTONIN REUPTAKE INHIBITORS; RANDOMIZED CONTROLLED-TRIALS; CLINICAL-TRIALS; DOUBLE-BLIND; CONTINUATION TREATMENT; PROPHYLACTIC EFFICACY; RECURRENT DEPRESSION; RELAPSE PREVENTION; BIPOLAR DISORDERS; SYMPTOM REDUCTION Multiple languages Psychiatry; Psychology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/29025