Effects of selective serotonin reuptake inhibitors (SSRIs) on suicide: A network meta-analysis of double-blind randomized trials

被引:2
作者
Li, Yuling [1 ,2 ]
Chen, Chengfeng [1 ,2 ]
Chen, Qinghua [1 ,2 ]
Yuan, Shiqi [1 ,2 ]
Liang, Wanyuan [2 ]
Zhu, Yikang [3 ]
Zhang, Bin [4 ]
机构
[1] Guangzhou Med Univ, Mental Hlth Coll, Guangzhou, Peoples R China
[2] Guangzhou Med Univ, Dept Psychiat, Affiliated Brain Hosp, Guangzhou, Peoples R China
[3] Shanghai Jiao Tong Univ, Sch Med, Shanghai Mental Hlth Ctr, Shanghai Key Lab Psychot Disorders, Shanghai, Peoples R China
[4] Tianjin Med Univ, Tianjin Anding Hosp, Inst Mental Hlth, Tianjin, Peoples R China
关键词
SSRIs; Suicidal ideation; Suicidal behavior; Mental disorder; MAJOR DEPRESSIVE DISORDER; PLACEBO-CONTROLLED TRIAL; MULTICENTER DOUBLE-BLIND; ANTIDEPRESSANT TREATMENT; CLINICAL-TRIAL; FLUOXETINE; ADOLESCENTS; CHILDREN; SAFETY; ESCITALOPRAM;
D O I
10.1016/j.psychres.2024.115917
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
The relationship between the use of selective serotonin reuptake inhibitors (SSRIs) and suicide risk in patients with mental disorders remains controversial. We conducted a network meta-analysis to examine the effects of SSRIs on suicide risk in patients with mental disorders. A comprehensive search was conducted across PubMed, Web of Science, PsycINFO, CENTRAL, Wanfang Database, and China National Knowledge Infrastructure for articles published until December 19, 2023. The main outcomes were suicidal ideation and instances of suicidal behavior. We included 29 double-blind randomized trials in our analysis. The findings suggest that SSRIs primarily offer short-term protection against suicidal ideation. By week 2, paroxetine, fluoxetine, escitalopram, and non-SSRI treatments were linked to a decreased suicide risk compared with a placebo, with the exception of sertraline. This protective effect was diminished by week 8. In contrast, studies on instances of suicidal behavior from weeks 1 to 10 found no significant difference in efficacy between SSRIs, non-SSRIs, and placebo. These results indicate that SSRIs may offer short-term protection against suicidal ideation. However, their long-term effectiveness in mitigating suicidal ideation and preventing suicidal behaviors is limited.
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页数:10
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