Journal of Psychopharmacology最新文献

{"title":"Impact of psychedelics on craving in addiction: A systematic review.","authors":"Sophie-Athéna Chapron, Guilhem Bonazzi, Laura Di Lodovico, Julia de Ternay, Camille Landmann, Mikail Nourredine, Francesco Salvo, Ben Sessa, Ravi Das, Benjamin Rolland, Albert Garcia-Romeu, Marc Auriacombe","doi":"10.1177/02698811241308613","DOIUrl":"https://doi.org/10.1177/02698811241308613","url":null,"abstract":"<p><strong>Background: </strong>In the context of the need to increase treatment options for substance use disorders, recent research has evaluated the therapeutic potential of psychedelics. However, there is an incomplete understanding of psychedelics' effects on craving, a core symptom of addictive disorders and a predictor of substance use and relapse.</p><p><strong>Aims: </strong>To determine if the use of psychedelics is associated with changes in craving in humans.</p><p><strong>Methods: </strong>A systematic review of the literature, using PubMed, PsycInfo, and Scopus databases up to May 2023. We included all studies assessing any substance craving levels after psychedelic use (protocol registration number CRD42021242856).</p><p><strong>Results: </strong>Thirty-eight published articles were included, corresponding to 31 studies and 2639 participants, pertaining either to alcohol, opioid, cocaine, or tobacco use disorders. Twelve of the 31 included studies reported a significant decrease in craving scores following psychedelic use. All but two studies had methodological issues, leading to moderate to high risk of bias scores.</p><p><strong>Conclusions: </strong>Some psychedelics may show promising anti-craving effects, yet the diversity and high risk of bias of extant studies indicate that these results are to be considered with caution. Further well-controlled and larger-scale trials should be encouraged.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811241308613"},"PeriodicalIF":4.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of vortioxetine in the acute treatment of major depressive disorder: A systematic review and meta-analysis.","authors":"Isabella Berardelli, Elena Rogante, Federico Formica, Riccardo Iannazzo, Attilio Valerio Mammoliti, Raffaele Riccioni, Skender Veizi, Roger S McIntyre, Maurizio Pompili","doi":"10.1177/02698811241309612","DOIUrl":"https://doi.org/10.1177/02698811241309612","url":null,"abstract":"<p><strong>Background: </strong>Among the available pharmacological treatments for acute major depressive disorder (MDD), vortioxetine, a serotonin transporter inhibitor (SERT), has been widely used for its multimodal action on serotonin neurotransmission, which produces essential changes also on glutamate, gamma amino butyric acid (GABA), norepinephrine, acetylcholine, and dopamine.</p><p><strong>Aim: </strong>This systematic review and meta-analysis aimed to evaluate the acute efficacy of vortioxetine across multiple dosing and to evaluate whether there is a dose-response effect and as well there is a dose-response issue with respect to side effects in acute depression.</p><p><strong>Methods: </strong>According to PRISMA guidelines, we systematically searched three major electronic databases (PubMed/MEDLINE, PsycINFO, and Cochrane Central Register of Controlled Trials) for Randomized Controlled Trial (RCT) studies published between January 2013 and April 2024. Twenty-four studies were included in the review and two meta-analyses were conducted to determine whether the mean Montgomery-Asberg Depression Rating Scale (MADRS) scale values in the placebo groups differ significantly from the mean MADRS scale values in the group receiving vortioxetine 10 mg or vortioxetine 20 mg.</p><p><strong>Results: </strong>Vortioxetine significantly improved acute depression severity, anxiety symptoms, and cognitive function, with high response and remission rates in acute MDD. It was also well tolerated with a relatively low occurrence of severe or serious treatment-emergent adverse events (TEAEs). Observing the results of the meta-analysis, the effect was significant for both vortioxetine 10 and 20 mg, with a greater effect size for vortioxetine 20 mg.</p><p><strong>Conclusion: </strong>Vortioxetine should be considered efficacious as a first- and second-line therapy.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811241309612"},"PeriodicalIF":4.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges for switching central nervous system and psychiatric medication products: A review of the literature.","authors":"Ric M Procyshyn, Martin A Katzman, Howard C Margolese, Ofer Agid, Pierre M Blier","doi":"10.1177/02698811241301219","DOIUrl":"https://doi.org/10.1177/02698811241301219","url":null,"abstract":"<p><strong>Background: </strong>Switching between versions of medication products happens commonly despite challenges in achieving bioequivalence and therapeutic equivalence. Central nervous system and psychiatric drugs, especially those that are technically demanding to manufacture and have complex pharmacokinetic properties, such as long-acting injectables (LAIs), pose particular challenges to bioequivalence and safe and efficacious drug switching.</p><p><strong>Aims: </strong>To assess whether drugs deemed \"bioequivalent\" are truly interchangeable in drug switching.</p><p><strong>Methods: </strong>We assessed the published literature from January 2017 through June 2023 on PubMed using the MeSH terms \"drugs, generic\" OR \"equivalency, generic\" combined with terms for different psychiatric drug classes.</p><p><strong>Results: </strong>While most of the published studies returned in the search found that switching drug products was safe and clinically comparable, data on most drug classes other than those primarily indicated in the treatment of seizure disorder were sparse. Some studies also provided evidence that real-world outcomes such as adherence and hospitalizations may also be affected by switching. In addition, a review of bioequivalence testing guidance showed inconsistency across agencies and a lack of product-specific guidance from Health Canada, which raises questions about potential claims of bioequivalence for more complex products such as LAIs.</p><p><strong>Conclusions: </strong>Overall, given the difficulty in treating mental health disorders, prescribers should be cautious when switching products and formulations in a patient who has been stabilized on a drug.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811241301219"},"PeriodicalIF":4.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic bupropion treatment reduces long-access cocaine self-administration in male and female rats.","authors":"Taylor J Templeton-Jager, Siga Diarra, Leslie K Kelley, Nicholas W Gilpin","doi":"10.1177/02698811241312680","DOIUrl":"https://doi.org/10.1177/02698811241312680","url":null,"abstract":"<p><strong>Background: </strong>More than 1 million people in the United States meet the criteria for cocaine use disorder (CUD), and over 19,000 people died from cocaine-related overdoses in 2020, but there are currently no FDA-approved medications for the treatment of CUD. Bupropion is an antidepressant currently prescribed to treat depression and nicotine addiction that acts by inhibiting norepinephrine and dopamine transporters.</p><p><strong>Methods: </strong>In this study, we tested the effect of several doses of systemic bupropion on cocaine self-administration in male and female Wistar rats. In our first experiment, rats self-administered cocaine solution intravenously and were pretreated with systemic bupropion before self-administration sessions. In our second experiment, rats were pre-treated with bupropion before completing tests of locomotor activity and anxiety-like behavior.</p><p><strong>Results: </strong>We found that high doses of systemically administered bupropion (60 mg/kg) attenuated cocaine self-administration in male and female rats during extended-access (6 h) sessions. We also found that the highest dose (60 mg/kg) of systemic bupropion was more efficacious in females relative to males during the first hour of operant sessions. Systemic bupropion did not alter locomotor activity, inactive lever presses, or food intake. The Estrous cycle did not influence cocaine intake with or without bupropion.</p><p><strong>Conclusion: </strong>Our finding that bupropion attenuates cocaine self-administration suggests that bupropion may have promise for reducing cocaine use in humans.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811241312680"},"PeriodicalIF":4.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward effective oxytocin interventions in autism: Overcoming challenges and harnessing opportunities.","authors":"Grazia Ricchiuti, Elise Tuerlinckx, Aymara Taillieu, Jellina Prinsen, Jean Steyaert, Bart Boets, Kaat Alaerts","doi":"10.1177/02698811241309621","DOIUrl":"https://doi.org/10.1177/02698811241309621","url":null,"abstract":"<p><p>Intranasal administration of oxytocin is emerging as a potential pharmacological option for mitigating social difficulties and regulating stress in autism spectrum disorder. However, initial single-dose and multiple-dose trials showed mixed results, with some demonstrating improvements in social and repetitive behavior and others showing no benefit over placebo. This perspective aims to elucidate factors contributing to this variability and to highlight pitfalls and opportunities in the field. We identified two major factors: design-related elements and individual participant characteristics. Pertaining to design-related elements, optimal dosing regimens have yet to be established, but appear to favor moderate intervention durations (i.e., 4-6 weeks) with intermittent and intermediate dosing (i.e., 24-32 IU every other day). Also, the context of the intervention seems crucial, as enhanced outcomes are mainly observed when oxytocin administration is paired with a socially stimulating and supporting environment. In addition, more adequate outcome measures have to be established to effectively assess oxytocin's impact, including behavioral scales and objective biophysiological markers tapping into stress and neurophysiological regulation. Future research should also account for individual participant differences in biological sex, developmental stage and cognitive and adaptive functioning, and incorporate (epi)genetic screening to identify responders. Overall, refining study designs and personalizing intervention protocols are essential for optimizing oxytocin's prosocial and anxiolytic effect in autism.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811241309621"},"PeriodicalIF":4.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catalyst for change: Psilocybin's antidepressant mechanisms-A systematic review.","authors":"Joshua Liebnau, Felix Betzler, André Kerber","doi":"10.1177/02698811241312866","DOIUrl":"https://doi.org/10.1177/02698811241312866","url":null,"abstract":"<p><strong>Background: </strong>Recent clinical trials suggest promising antidepressant effects of psilocybin, despite methodological challenges. While various studies have investigated distinct mechanisms and proposed theoretical opinions, a comprehensive understanding of psilocybin's neurobiological and psychological antidepressant mechanisms is lacking.</p><p><strong>Aims: </strong>Systematically review potential antidepressant neurobiological and psychological mechanisms of psilocybin.</p><p><strong>Methods: </strong>Search terms were generated based on existing evidence of psilocybin's effects related to antidepressant mechanisms. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, 15 studies were systematically reviewed, exploring various therapeutic change principles such as brain dynamics, emotion regulation, cognition, self-referential processing, connectedness, and interpersonal functioning.</p><p><strong>Results: </strong>Within a supportive setting, psilocybin promoted openness, cognitive and neural flexibility, and greater ability and acceptance of emotional experiences. A renewed sense of connectedness to the self, others, and the world emerged as a key experience. Imaging studies consistently found altered brain dynamics, characterized by reduced global and within default mode network connectivity, alongside increased between-network connectivity.</p><p><strong>Conclusions: </strong>Together, these changes may create a fertile yet vulnerable window for change, emphasizing the importance of a supportive set, setting, and therapeutic guidance. The results suggest that psilocybin, within a supportive context, may induce antidepressant effects by leveraging the interplay between neurobiological mechanisms and common psychotherapeutic factors. This complements the view of purely pharmacological effects, supporting a multileveled approach that reflects various relevant dimensions of therapeutic change, including neurobiological, psychological, and environmental factors.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811241312866"},"PeriodicalIF":4.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomised double-blind, placebo-controlled trial of pramipexole in addition to mood stabilisers for patients with treatment-resistant bipolar depression (the PAX-BD study).","authors":"R Hamish McAllister-Williams, Nicola Goudie, Lumbini Azim, Victoria Bartle, Michael Berger, Chrissie Butcher, Thomas Chadwick, Emily Clare, Paul Courtney, Lyndsey Dixon, Nichola Duffelen, Tony Fouweather, William Gann, John Geddes, Sumeet Gupta, Beth Hall, Timea Helter, Paul Hindmarch, Eva-Maria Holstein, Ward Lawrence, Phil Mawson, Iain McKinnon, Adam Milne, Aisling Molloy, Abigail Moore, Richard Morriss, Anisha Nakulan, Judit Simon, Daniel Smith, Bryony Stokes-Crossley, Paul Ra Stokes, Andrew Swain, Adeola Taiwo, Zoë Walmsley, Christopher Weetman, Allan H Young, Stuart Watson","doi":"10.1177/02698811241309622","DOIUrl":"https://doi.org/10.1177/02698811241309622","url":null,"abstract":"<p><strong>Background: </strong>Options for 'treatment-resistant bipolar depression' (TRBD) are limited. Two small, short-term, trials of pramipexole suggest it might be an option.</p><p><strong>Aims: </strong>To evaluate the clinical effectiveness and safety of pramipexole in the management of TRBD.</p><p><strong>Methods: </strong>A multi-centre randomised, double-blind controlled trial including participants ⩾18 years old with TRBD (failure to respond, tolerate or clinical contraindication/patient refusal of ⩾2 of quetiapine, olanzapine, lamotrigine or lurasidone) randomised 1:1 to pramipexole (max 2.5 mg/day salt weight) or placebo added to ongoing mood stabiliser (<i>n</i> = 39). Primary outcome: Quick Inventory of Depressive Symptoms, Self-rated (QIDS-SR) at 12 weeks. Up to 48 weeks follow-up.</p><p><strong>Results: </strong>Pramipexole (<i>n</i> = 18) was associated with a greater reduction in QIDS-SR score at 12 weeks versus placebo (<i>n</i> = 21, 4.4 (4.8) vs 2.1 (5.1)): a medium sized (<i>d</i> = -0.72) but not statistically significant difference (95% CI: -0.4 to 6.3, <i>p</i> = 0.087). Similarly, there was a non-significant approximate 2-point (<i>d</i> = -0.76) improvement in pleasure at 6 weeks (95% CI: -0.11 to 4.20). Significant advantages of pramipexole on QIDS-SR score (6.28 points: 95% CI: 1.85-10.71) and psychosocial function (5.36 points: 95% CI: 0.38-10.35) were seen at 36 weeks post-randomisation, and on the response (46% vs 6%; <i>p</i> = 0.026) and remission (31% vs 0%; <i>p</i> = 0.030) rates at trial exit (48 weeks or last available data after 16 weeks for those affected by the early study closure). Hypomania ratings were significantly higher at 12 weeks. Otherwise, pramipexole was well tolerated.</p><p><strong>Conclusions: </strong>Clinically large, but statistically non-significant, effects of pramipexole on depression at 12 weeks, with significant longer-term benefits on mood and function were observed. Pramipexole use was complicated by dose titration and increased hypomanic symptoms. The small sample size limits interpretation. Furthermore, larger randomised placebo-controlled trials are warranted.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811241309622"},"PeriodicalIF":4.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between paraoxonase-1 activity and therapeutic drug monitoring indicators in schizophrenia patients treated with olanzapine: A cross-sectional study.","authors":"Tzu-Hua Wu, Shu-Chin Hu, Nailis Sylfa, Jiahn-Haur Liao, Ahmad Raza, Bi-Li Chen, Chun-Hsin Chen, Mong-Liang Lu","doi":"10.1177/02698811241311459","DOIUrl":"https://doi.org/10.1177/02698811241311459","url":null,"abstract":"<p><strong>Objective: </strong>Therapeutic drug monitoring (TDM) indicators have been suggested to predict overall outcome responses to olanzapine (OLZ) treatments in terms of efficacy and metabolic syndrome. This study aimed to investigate whether paraoxonase-1 (PON-1) activity can be used to predict schizophrenia patient outcomes.</p><p><strong>Methods: </strong>Schizophrenic patients (<i>N</i> = 50) aged between 20 and 65 years who received OLZ treatment were recruited, and their Positive and Negative Syndrome Scale scores, PON-1 activity, and olanzapine drug levels normalized by dose (OLZ/D) and its metabolite N-desmethyl-olanzapine (DMO), together with biochemical parameters, were determined.</p><p><strong>Results: </strong>PON-1 activity and OLZ/D were significantly correlated in 50 patients (correlation coefficient, <i>r</i> = 0.355; <i>p</i> = 0.0115). There was also a statistically significant correlation between the ratio of PON-1 activity normalized by homocysteine (Hcy) and OLZ/D (correlation coefficient <i>r</i> = 0.361; <i>p</i> = 0.01) and a significant negative correlation between the ratio of PON-1 activity normalized by Hcy and triglyceride/high-density lipoprotein (TG/HDL; correlation coefficient <i>r</i> = -0.328; <i>p</i> = 0.02).</p><p><strong>Conclusions: </strong>PON-1 activity can be used as an alternative tool for monitoring TDM through the measurement of OLZ together with its metabolite, DMO, to identify patients who have higher activity. Those who show an optimal response or who have lower activity might have greater cardiometabolic risk under long-term olanzapine treatment. Longitudinal monitoring is warranted to confirm such observations.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811241311459"},"PeriodicalIF":4.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haloperidol dopamine receptor occupancy and antagonism correspond to delirium agitation scores and EPS risk: A PBPK-PD modeling analysis.","authors":"Paul M Burkat","doi":"10.1177/02698811241309620","DOIUrl":"https://doi.org/10.1177/02698811241309620","url":null,"abstract":"<p><strong>Background: </strong>Delirium is a severe neuropsychiatric disorder associated with increased morbidity and mortality. Numerous precipitating factors and etiologies merge into the pathophysiology of this condition which can be marked by agitation and psychosis. Judicious use of antipsychotic medications such as intravenous haloperidol reduces these symptoms and distress in critically ill individuals.</p><p><strong>Aims: </strong>This study aimed to develop a physiologically-based pharmacokinetic (PBPK) model for the antipsychotic medication haloperidol; estimate plasma and unbound interstitial brain concentrations for repetitive haloperidol administrations used in hyperactive delirium treatment; determine dopamine receptor occupancy and antagonism under these conditions; and correlate these results with Richmond Agitation-Sedation Scale (RASS) scores and the risk of developing extrapyramidal symptoms (EPSs).</p><p><strong>Methods: </strong>The PBPK model for single and repetitive administrations of peroral and intravenous haloperidol was developed with PK-Sim software. The pharmacodynamic (PD) model for RASS scores with haloperidol unbound interstitial brain concentration passed as the regressor was developed with the MonolixSuite 2021R platform.</p><p><strong>Results: </strong>Peak haloperidol plasma and unbound interstitial brain concentrations following a single 2 mg intravenous dose are 32 ± 5 nM and 2.4 ± 0.4 nM. With repetitive administrations, dopamine receptor occupancy is 70%-83% and D2_LR antagonism is 1%-10%. Variations in dopamine receptor occupancy correlate with changes in RASS scores in individuals with hyperactive delirium. There is a linear association between the odds ratio of developing EPS and peak D2_LR antagonism as functions of dopamine receptor occupancy.</p><p><strong>Conclusions: </strong>Haloperidol dopamine receptor occupancy time course and D2_LR antagonism parallel RASS score changes and EPS risk, respectively.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811241309620"},"PeriodicalIF":4.5,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of treatment with hypnotics with suicide and attempted suicide: A nationwide cohort study.","authors":"Nikolaj Kjær Høier, Trine Madsen, Adam P Spira, Keith Hawton, Poul Jennum, Merete Nordentoft, Annette Erlangsen","doi":"10.1177/02698811241309619","DOIUrl":"https://doi.org/10.1177/02698811241309619","url":null,"abstract":"<p><strong>Background: </strong>Hypnotics have been linked to suicidal behaviors. While existing evidence has established findings of associations, more knowledge is needed regarding benzodiazepine (BZD) and non-benzodiazepine (n-BZD) hypnotics.</p><p><strong>Aim: </strong>To examine whether individuals in treatment with hypnotics had higher rates of suicide and suicide attempts than those not in treatment.</p><p><strong>Methods: </strong>A longitudinal nationwide cohort design was applied to individual-level register data, including all individuals aged 15+ years who lived in Denmark from 1995 to 2021. Incidence rate ratios (IRR) for suicide and suicide attempts were estimated using Poisson regression models. Using the National Prescription Registry, individuals who redeemed prescriptions for hypnotics at pharmacies were identified. Death by suicide was identified in the Cause of Death Register.</p><p><strong>Results: </strong>A total of 7,311,630 individuals were observed over 122,681,369 person-years. In all, 678 males and 553 females died by suicide while in treatment with BZD, resulting in respective adjusted IRRs of 2.1 (95% CI: 1.9-2.4) and 2.6 (95% CI: 2.3-3.0), when compared to those not in treatment. A total of 1774 males and 1212 females died by suicide while in treatment with n-BZD and the adjusted IRRs were 3.4 (95% CI: 3.1-3.7) and 3.6 (95% CI: 3.4-3.9), respectively.</p><p><strong>Conclusions: </strong>While confounding by indication is likely to be a major contributor, the fact that individuals in treatment with BZD or n-BZDs had higher rates of suicide and suicide attempts when compared to those not in treatment emphasizes the need to carefully monitor their mental state.</p>","PeriodicalId":16892,"journal":{"name":"Journal of Psychopharmacology","volume":" ","pages":"2698811241309619"},"PeriodicalIF":4.5,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}