选择性5-羟色胺再摄取抑制剂类抗抑郁药与自杀风险：一项对14857例自杀案例的对照法医数据库研究
Selective serotonin reuptake inhibitor antidepressants and the risk of suicide: a controlled forensic database study of 14,857 suicides.
作者信息
Isacsson G, Holmgren P, Ahlner J
机构信息
Neurotec, Division of Psychiatry, Karolinska Institute, Stockholm, Sweden.
出版信息
Acta Psychiatr Scand. 2005 Apr;111(4):286-90. doi: 10.1111/j.1600-0447.2004.00504.x.
OBJECTIVE
To test the hypothesis that selective serotonin reuptake inhibitor (SSRI) antidepressants may have a suicide emergent effect, particularly in children and adolescents.
METHOD
Detections of different antidepressants in the forensic toxicological screening of 14 857 suicides were compared with those in 26,422 cases of deaths by accident or natural causes in Sweden 1992-2000.
RESULTS
There were 3411 detections of antidepressants in the suicides and 1538 in the controls. SSRIs had lower odds ratios than the other antidepressants. In the 52 suicides under 15 years, no SSRIs were detected. In 15-19-year age group, SSRIs had lower relative risk in suicides compared with non-SSRIs.
CONCLUSION
The hypothesis that treatment of depressed individuals with SSRIs leads to an increased risk of suicide was not supported by this analysis of the total suicidal outcome of the nationwide use of SSRIs in Sweden over a period of 9 years, either in adults or in children or adolescents.
目的
检验选择性5-羟色胺再摄取抑制剂（SSRI）类抗抑郁药可能产生自杀突发效应这一假设，尤其是在儿童和青少年中。
方法
将1992年至2000年瑞典14857例自杀案例法医毒理学筛查中不同抗抑郁药的检测结果，与26422例意外死亡或自然死亡案例的检测结果进行比较。
结果
自杀案例中有3411次检测到抗抑郁药，对照案例中有1538次。SSRI类药物的优势比低于其他抗抑郁药。在15岁以下的52例自杀案例中，未检测到SSRI类药物。在15至19岁年龄组中，与非SSRI类药物相比，自杀案例中SSRI类药物的相对风险较低。
结论
对瑞典9年间全国范围内使用SSRI类药物的总体自杀结果进行分析，无论是在成年人还是儿童或青少年中，均未支持使用SSRI类药物治疗抑郁症患者会增加自杀风险这一假设。
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