@article{ref1,
title="Association between quetiapine use and self-harm outcomes among people with recorded personality disorder in UK primary care: a self-controlled case series analysis",
journal="Journal of psychopharmacology",
year="2022",
author="Hayes, Joseph F. and Hardoon, Sarah and Deighton, Jessica and Viding, Essi and Osborn, David Pj",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Quetiapine is frequently prescribed to people with personality disorder diagnoses, but this is not supported by evidence or treatment guidelines. AIMS: To examine associations between periods of quetiapine prescribing and self-harm events in people with personality disorder. <br><br>METHOD: Self-controlled case series using linked primary care and hospital records covering the period 2007-2017. We calculated incidence rates and incidence rate ratios (IRRs) for self-harm events during periods when people were prescribed (exposed to) quetiapine, as well as periods when they were unexposed or pre-exposed to quetiapine. <br><br>RESULTS: We analysed data from 1,082 individuals with established personality disorder diagnoses, all of whom had at least one period of quetiapine prescribing and at least one self-harm episode. Their baseline rate of self-harm (greater than 12 months before quetiapine treatment) was 0.52 episodes per year. Self-harm rates were elevated compared to the baseline rate in the month after quetiapine treatment was commenced (IRR 1.85; 95% confidence interval (CI) 1.46-2.34) and remained raised throughout the year after quetiapine treatment was started. However, self-harm rates were highest in the month prior to quetiapine initiation (IRR 3.59; 95% CI 2.83-4.55) and were elevated from 4 months before quetiapine initiation, compared to baseline. <br><br>CONCLUSION: Self-harm rates were elevated throughout the first year of quetiapine prescribing, compared to the baseline rate. However, rates of self-harm reduced in the month after patients commenced quetiapine, compared to the month before quetiapine was initiated. Self-harm rates gradually dropped over a year of quetiapine treatment. Quetiapine may acutely reduce self-harm. Longer-term use and any potential benefits need to be balanced with the risk of adverse events.<p /> <p>Language: en</p>",
language="en",
issn="0269-8811",
doi="10.1177/02698811221131990",
url="http://dx.doi.org/10.1177/02698811221131990"
}