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Citation |
Reutfors J, Bahmanyar S, Jonsson EG, Brandt L, Bodén R, Ekbom A, Osby U. Schizophr. Res. 2013; 150(2-3): 416-420. |
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Affiliation |
Centre for Pharmacoepidemiology (CPE), Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden. Electronic address: johan.reutfors@ki.se. |
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Copyright |
(Copyright © 2013, Elsevier Publishing) |
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DOI |
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PMID |
24094723 |
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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. Language: en |