Drugs Associated with More Suicidal Ideations Are also Associated with More Suicide Attempts 英文参考文献.docVIP

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Drugs Associated with More Suicidal Ideations Are also Associated with More Suicide Attempts 英文参考文献.doc

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Drugs Associated with More Suicidal Ideations Are also Associated with More Suicide Attempts 英文参考文献

DrugsAssociatedwithMoreSuicidalIdeationsArealso AssociatedwithMoreSuicideAttempts HenryT.Robertson1,DavidB.Allison1,2* 1DepartmentofBiostatistics,UniversityofAlabamaatBirmingham,RyalsSchoolofPublicHealth,Birmingham,Alabama,UnitedStatesofAmerica,2ClinicalNutrition ResearchCenter,UniversityofAlabamaatBirmingham,Birmingham,Alabama,UnitedStatesofAmerica Abstract Context:Inrandomizedcontrolledtrials(RCTs),somedrugs,includingCB1antagonistsforobesitytreatment,havebeen showntocauseincreasedsuicidalideation.Akeyquestioniswhetherdrugsthatincreaseorareassociatedwithincreased suicidal ideations are also associated with suicidal behavior, or whether drug–induced suicidal ideations are unlinked epiphenomenathatdonotpresagethemoretroublingandpotentiallyirrevocableoutcomeofsuicidalbehavior. Thisis difficulttodetermineinRCTsbecauseoftherarityofsuicidalattemptsandcompletions. Objective: To determine whether drugs associated with more suicidal ideations are also associated with more suicide attemptsinlargespontaneousadverseevent(AE)reportdatabases. Methodology:GeneralizedlinearmodelswithnegativebinomialdistributionwerefittedtoFoodandDrugAdministration (FDA)AdverseEvent(AE)ReportingSystem(AERS)datafrom2004to2008.Atotalof1,404,470AEsfrom832drugswere analyzedasafunctionofreportsofsuicidalideations;othernon-suicidaladversereactions;drugclass;proportionofreports frommales;andaverageageofsubjectforwhichAEwasfiled.Drugwastreatedastheunitofanalysis,thusthestatistical modelseffectivelyhad832observations. MainOutcomeMeasures:Reportedsuicideattemptsandcompletedsuicidesperdrug. Results:832drugs,rangingfromabacavirtozopiclone,wereevaluated.The832drugs,asprimarysuspectdrugsinagiven adverse event, accounted for over 99.9% of recorded AERS. Suicidal ideations had a significant positive association with suicideattempts(p,.0001)andhadanapproximately131-foldstrongermagnitudeofassociationthannon-suicidalAERs, afteradjustingfordrugclass,gender,andage. Conclusions:InAEreports,drugsthatareassociat