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Medication and suicide risk in schizophrenia: A nested case-control study
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2013 (English)In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 150, no 2-3, 416-420 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2013. Vol. 150, no 2-3, 416-420 p.
National Category
URN: urn:nbn:se:uu:diva-209408DOI: 10.1016/j.schres.2013.09.001ISI: 000326180700017PubMedID: 24094723OAI: oai:DiVA.org:uu-209408DiVA: diva2:657288
Available from: 2013-10-18 Created: 2013-10-18 Last updated: 2013-12-02Bibliographically approved

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Bodén, Robert
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Psychiatry, University Hospital
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