Emulating a randomized clinical trial with real-world data to evaluate the effect of antidepressant use in PTSD patients with high suicide risk.

IF 3.2 3区医学 Q2 PSYCHIATRY

Frontiers in Psychiatry Pub Date : 2025-01-28 eCollection Date: 2024-01-01 DOI:10.3389/fpsyt.2024.1526488

Oshin Miranda, Xiguang Qi, M Daniel Brannock, Ryan Whitworth, Thomas Kosten, Neal David Ryan, Gretchen L Haas, Levent Kirisci, LiRong Wang

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Abstract

Introduction: Post-Traumatic Stress Disorder (PTSD) entails behavioral changes with increased risk of suicide, and there is no consensus on the preferred antidepressants for treatment of those PTSD patients who are at elevated risk for suicide.

Methods: We conducted a clinical trial emulation study comparing suicide-related events (SREs) among those patients' initiating antidepressants within 60 days after a qualifying SRE. Patients were followed from initiation of antidepressant until any of the following: treatment cessation, switching, death, or loss to follow-up. The outcome is a new onset of an SRE.

Results: Citalopram exhibited a significantly fewer case with new SREs compared to other most used antidepressants such as venlafaxine, duloxetine, and mirtazapine-even after adjusting for multiple comparisons and other covariants.

Discussion: Findings suggest potential risks associated with certain antidepressants in the PTSD population, emphasizing cautious prescription considerations.

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来源期刊

Frontiers in Psychiatry Medicine-Psychiatry and Mental Health

CiteScore

6.20

自引率

8.50%

发文量

2813

审稿时长

14 weeks

期刊介绍： Frontiers in Psychiatry publishes rigorously peer-reviewed research across a wide spectrum of translational, basic and clinical research. Field Chief Editor Stefan Borgwardt at the University of Basel is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. The journal''s mission is to use translational approaches to improve therapeutic options for mental illness and consequently to improve patient treatment outcomes.