January 08, 2014
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Suicide attempt risk in children similar with all prescription antidepressants

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Risk of suicide attempt did not differ among children prescribed newer selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors and those prescribed fluoxetine, according to new study data.

William O. Cooper, MD, MPH, of Vanderbilt University School of Medicine, and colleagues examined 36,842 children aged 6 to 18 years who had medically treated suicide attempts and were new users of one of the antidepressants of interest in the study (paroxetine, sertraline, citalopram, escitalopram, venlafaxine or fluoxetine) to determine the occurrence of suicide attempts associated with each drug.

Four children in the study completed suicide. Suicide attempts ranged from 24 per 1,000 person-years to 29.1 per 1,000 person-years. Suicide attempts did not differ significantly among children assigned sertraline, paroxetine, citalopram, escitalopram, venlafaxine or fluoxetine. Participants taking multiple antidepressants were at higher risk of treated suicide attempts (adjusted RR=1.7; 95% CI, 1.1-2.62) compared with those assigned fluoxetine.

“We found no evidence of increased risk for [selective serotonin reuptake inhibitor] or [serotonin-norepinephrine reuptake inhibitor] antidepressants compared with fluoxetine for new users of antidepressants in the Tennessee Medicaid population,” the researchers wrote. “Use of any of the individual drugs studied would not be expected to increase risk for serious suicide attempts compared with the others”

Disclosure: The study was funded in part by NIH and the National Institute of Mental Health. One researcher reports financial ties with Eli Lilly, Euthymics Bioscience, Forest Pharmaceuticals and Pfizer.