Rubino, Annalisa, Roskell, Neil, Tennis, Pat, Mines, Daniel, Weich, Scott and Andrews, Elizabeth (2006) Risk of suicide during venlafaxine and comparator antidepressants treatment. In: 22nd International Conference on Pharmacoepidemiology & Therapeutic Risk Management, Lisbon, Portugal, Aug 24 - 27, 2006. Published in: Pharmacoepidemiology and Drug Safety, Vol.15 (Suppl. 1). S40-S41. doi:10.1136/bmj.39041.445104.BE ISSN 1053-8569.
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Abstract
Objective. To compare the risk of suicide in adults using the antidepressant venlafaxine compared with citalopram, fluoxetine, and dothiepin.
Design. Retrospective cohort study.
Setting. UK General Practice Research Database.
Participants. 219 088 patients, aged 18-89 years, who were prescribed venlafaxine, citalopram, fluoxetine, or dothiepin from 1995 to 2005.
Main outcome measures. Completed suicide and attempted suicide.
Results. Venlafaxine users had a higher burden of risk factors for suicide, including previous suicide attempts and proxies for severe depression or depression that was difficult to treat. In the analysis for completed suicides, unadjusted and adjusted hazard ratios for venlafaxine compared with citalopram were 2.44 (95% confidence interval 1.12 to 5.31) and 1.70 (0.76 to 3.80), for venlafaxine compared with fluoxetine were 2.85 (1.37 to 5.94) and 1.63 (0.74 to 3.59), and for venlafaxine compared with dothiepin were 2.54 (1.07 to 6.02) and 1.31 (0.53 to 3.25). Compared with other study drugs, venlafaxine was also associated with an increased risk of attempted suicide, but adjustment for measured confounders substantially reduced the hazard ratios.
Conclusions. Venlafaxine use was consistently associated with higher risk of suicide compared with citalopram, fluoxetine, and dothiepin. Venlafaxine users had a higher burden of suicide risk factors, however, and adjustment for measured confounders substantially reduced the excess risks. Since the secondary data used in this analysis allowed only indirect and partial measurements of potential confounders, it is possible that residual confounding explains much, if not all, of the observed excess risk.
| Item Type: | Conference Item (Paper) |
|---|---|
| Subjects: | R Medicine > RS Pharmacy and materia medica |
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
| Journal or Publication Title: | Pharmacoepidemiology and Drug Safety |
| Publisher: | John Wiley & Sons Ltd. |
| ISSN: | 1053-8569 |
| Official Date: | August 2006 |
| Dates: | Date Event August 2006 Published |
| Volume: | Vol.15 |
| Number: | Suppl. 1 |
| Number of Pages: | 2 |
| Page Range: | S40-S41 |
| DOI: | 10.1136/bmj.39041.445104.BE |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Restricted or Subscription Access |
| Conference Paper Type: | Paper |
| Title of Event: | 22nd International Conference on Pharmacoepidemiology & Therapeutic Risk Management |
| Type of Event: | Conference |
| Location of Event: | Lisbon, Portugal |
| Date(s) of Event: | Aug 24 - 27, 2006 |
| URI: | https://wrap.warwick.ac.uk/32590/ |
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