Comparison of antidepressant classes and the risk and timecourse of suicide attempts in adults: propensity matched, retrospectivecohort study

BackgroundPlacebo-controlled clinical trials have led to concern over possibleincreased risk of suicide-related events in some populations exposed toantidepressants.AimsTo evaluate the risk of suicide attempts by antidepressant drug class andthe presence or absence of depression.MethodA retrospective propensity-matched new-user cohort study was used tocompare participants with incident depression classified byantidepressant treatment with each other and with the generalpopulation.ResultsAmong the treated group, the suicide attempt rate peaked in the monthprior to diagnosis then decreased steadily over the next 6 months. Amongthe pharmacologically untreated group, the highest rate was seen in thesecond month after diagnosis. Cohorts with depression had significantlyhigher suicide attempt risk than the general population, but the treatedgroup did not differ significantly from the untreated group.ConclusionsPatients on antidepressants did not have significantly higher riskcompared with untreated patients. No significant differences wereobserved for patients treated with individual serotonin–noradrenalinereuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors(SSRIs) or by class (SSRI v. SNRI cohorts).