Table 1

Risk of suicide and suicide attempt combined in association with exposure to new-generation antidepressants

Number of comparisonsSummary estimate95% CIHeterogeneitySubgroup difference
kRRCILBCIUBI2
Drug classSSRI
Other AD
Any unspecified
19
21
21
1.19
1.28
1.87
0.88
0.90
1.55
1.60
1.80
2.25
96.0
96.2
89.3
Q=9.39
p=0.009
Main treatment indicationDepression
Any unspecified
41
20
1.35
1.65
1.10
1.26
1.65
2.17
95.6
93.1
Q=1.53
p=0.217
LocationNorth America
Europe
Other
21
36
4
0.82
1.82
1.73
0.68
1.51
0.84
0.99
2.20
3.57
65.5
95.7
10.8
Q=39.95
p<0.001
Older adult sample (≥65 years)Yes
No
Missing data
4
54
3
1.67
1.44
0.35
1.21
7.86
1.71
94.7
95.0
Q=0.09
p=0.764
Study designCohort
Case–control
37
24
1.59
1.22
1.27
1.00
1.99
1.50
96.4
79.7
Q=3.16
p=0.076
Study qualityHigh (≥7 points)
Low (<7 points)
49
12
1.36
1.92
1.15
1.21
1.61
3.03
94.4
96.5
Q=2.38
p=0.123
Covariate adjustmentYes
No
51
10
1.40
1.71
1.19
0.96
1.65
3.04
94.1
97.2
Q=0.54
p=0.460
fCOIYes
No
28
33
0.96
2.02
0.82
1.66
1.12
2.46
86.1
94.3
Q=37.17
p<0.001
  • Other AD, non-SSRI new-generation antidepressants (includes serotonin norepinephrine reuptake inhibitors (eg, duloxetine and venlafaxine) and atypical antidepressants (eg, mirtazapine and bupropion); CILB, CI lower bound; CIUB, CI upper bound; fCOI, financial conflicts of interest; RR, relative risk estimate; SSRI, selective serotonin reuptake inhibitors.