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Medication and suicide risk in schizophrenia: A nested case-control study

Reutfors, J. and Bahmanyar, S. and Jönsson, E.G. and Brandt, L. and Bodén, R. and Ekbom, A. and Ösby, U. (2013) Medication and suicide risk in schizophrenia: A nested case-control study. Schizophrenia Research, 150 (2-3). pp. 416-420. ISSN 09209964 (ISSN)

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Abstract

Introduction: Patients with schizophrenia are at increased risk of suicide, but data from controlled studies of pharmacotherapy in relation to suicide risk is limited. Aim: To explore suicide risk in schizophrenia in relation to medication with antipsychotics, antidepressants, and lithium. Methods: Of all patients with a first clinical discharge diagnosis of schizophrenia or schizoaffective disorder in Stockholm County between 1984 and 2000 (n=4000), patients who died by suicide within five years from diagnosis were defined as cases (n=84; 54% male). Individually matched controls were identified from the same population. Information on prescribed medication was retrieved from psychiatric records in a blinded way. Adjusted odds ratios [OR] of the association between medication and suicide were calculated by conditional logistic regression. Results: Lower suicide risk was found in patients who had been prescribed a second generation antipsychotic (clozapine, olanzapine, risperidone, or ziprasidone; 12 cases and 20 controls): OR 0.29 (95% confidence interval [CI], 0.09-0.97). When the 6 cases and 8 controls who had been prescribed clozapine were excluded, the OR was 0.23 (95% CI 0.06-0.89). No significant association was observed between suicide and prescription of any antipsychotic, depot injection antipsychotics, antidepressants, SSRI, or lithium. Conclusions: Lower suicide risk for patients who had been prescribed second generation antipsychotics may be related to a pharmacological effect of these drugs, to differences in adherence, or to differences in other patient characteristics associated with lower suicide risk. © 2013 Elsevier B.V.

Item Type: Article
Additional Information: Unmapped bibliographic data: LA - English [Field not mapped to EPrints] J2 - Schizophr. Res. [Field not mapped to EPrints] C2 - 24094723 [Field not mapped to EPrints] AD - Centre for Pharmacoepidemiology (CPE), Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden [Field not mapped to EPrints] AD - Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran [Field not mapped to EPrints] AD - Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden [Field not mapped to EPrints] AD - Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden [Field not mapped to EPrints] AD - Department of Neurobiology, Care Sciences and Society, Centre of Family Medicine (CeFAM), Karolinska Institutet, Stockholm, Sweden [Field not mapped to EPrints] AD - Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden [Field not mapped to EPrints] DB - Scopus [Field not mapped to EPrints]
Uncontrolled Keywords: Antidepressant drugs, Antipsychotic drugs, Case-control study, Lithium, Schizophrenia, Suicide, antidepressant agent, clozapine, lithium, neuroleptic agent, olanzapine, risperidone, ziprasidone, adult, article, case control study, controlled study, disease association, drug effect, drug response, drug use, female, human, major clinical study, male, observational study, outcome assessment, patient assessment, prescription, priority journal, risk assessment, risk factor, schizoaffective psychosis, schizophrenia, suicide, Antidepressant drugs, Antipsychotic drugs, Case-control study, Lithium, Schizophrenia, Suicide, Adolescent, Adult, Age Factors, Antidepressive Agents, Antipsychotic Agents, Case-Control Studies, Female, Humans, Lithium Chloride, Longitudinal Studies, Male, Middle Aged, Odds Ratio, Risk, Schizophrenia, Schizophrenic Psychology, Self-Injurious Behavior, Sex Factors, Suicide, Young Adult
Subjects: مقالات نمایه شده محققین دانشگاه در سایت ,Web of Science ,Scopus
Divisions: معاونت تحقیقات و فناوری
Depositing User: GOUMS
Date Deposited: 20 Apr 2015 08:06
Last Modified: 04 May 2015 16:57
URI: http://eprints.goums.ac.ir/id/eprint/1822

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