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首页> 外文期刊>The journal of clinical psychiatry >Risks of suicide and poisoning among elderly patients prescribed selective serotonin reuptake inhibitors: a retrospective cohort study.
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Risks of suicide and poisoning among elderly patients prescribed selective serotonin reuptake inhibitors: a retrospective cohort study.

机译：老年患者开具选择性5-羟色胺再摄取抑制剂的自杀和中毒风险：一项回顾性队列研究。

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BACKGROUND: Treatment with selective serotonin reuptake inhibitors (SSRIs) has been associated with increased suicide risk. Risks of suicide death and of poisoning were compared during periods of SSRI treatment versus periods without any antidepressant treatment among elderly patients. METHOD: In this retrospective cohort study, records from the Quebec Health Care Fund and Vital Statistics databases were obtained for patients 65 years and older who had filled a prescription for an SSRI between January 1998 and December 2004. Patients were followed from the filling date of the first SSRI prescription during the study period until death, the end of the first period extending for at least 365 days with no antidepressant supply, or December 31, 2004, whichever occurred first. RESULTS: The cohort included 128,229 patients (mean age = 75.4 years), 70% of whom were women. Numbers of suicide deaths (crude rate/100,000 patient-years) were 37 (23) during SSRI use, 16 (51) during other antidepressant use, 5 (54) during use of both an SSRI and another anti-depressant, and 29 (29) during no antidepressant use. The adjusted risk of suicide death (Cox regression model with time-dependent exposure) was not higher during SSRI use versus nonuse (hazard ratio [95% CI]): any SSRI = 0.64 (0.38 to 1.07), paroxetine = 0.71 (0.37 to 1.35), citalopram = 1.16 (0.59 to 2.25), and sertraline = 0.38 (0.16 to 0.93). The adjusted hazard ratio (95% CI) of poisoning was higher during SSRI use versus nonuse (1.16 [1.07 to 1.25]) and varied between SSRI agents from 0.93 (0.74 to 1.16) for fluoxetine to 1.45 (1.23 to 1.71) for fluvoxamine. CONCLUSION: Among elderly patients dispensed SSRIs, the risk of suicide death was not higher during periods of SSRI use compared to when antidepressants were not being used.
机译：背景：用选择性5-羟色胺再摄取抑制剂（SSRIs）治疗已增加自杀风险。比较SSRI治疗期间和未接受任何抗抑郁药治疗期间自杀死亡和中毒的风险。方法：在这项回顾性队列研究中，从魁北克卫生保健基金和生命统计数据库中获得了1998年1月至2004年12月间开具SSRI处方的65岁及65岁以上患者的记录。研究期间的第一个SSRI处方直到死亡，第一个SSRI处方的末期持续至少365天，无抗抑郁药供应，或2004年12月31日，以先到者为准。结果：该队列包括128,229名患者（平均年龄= 75.4岁），其中70％是女性。使用SSRI期间自杀死亡人数（粗暴率/ 100,000病人-年）为37（23），其他抗抑郁药使用期间为16（51），SSRI和另一种抗抑郁药同时使用时为5（54），以及29（ 29）在不使用抗抑郁药的情况下。使用SSRI期间的调整后自杀死亡风险（具有时间依赖性暴露的Cox回归模型）与未使用相比（风险比[95％CI]）不高：任何SSRI = 0.64（0.38至1.07），帕罗西汀= 0.71（0.37至0.37 1.35），西酞普兰= 1.16（0.59至2.25）和舍曲林= 0.38（0.16至0.93）。使用SSRI期间中毒的调整后中毒风险比（95％CI）高于未使用（1.16 [1.07至1.25]），SSRI剂之间的差异从氟西汀的0.93（0.74至1.16）到氟伏沙明的1.45（1.23至1.71）不等。结论：在使用SSRI的老年患者中，与不使用抗抑郁药时相比，使用SSRI期间自杀死亡的风险并不更高。

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