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This study describes methods for examining the association of these agents with suicide attempts and suicide deaths in more broadly generalizable samples than examined by the US Food and Drug Administration. An observational study of mood disorders was examined that includes three decades of prospective assessments. Because of sample size differences, two distinct longitudinal implementations of the propensity adjustment are used in separate analyses of antidepressants and antiepileptic drugs. Propensity score quintile\u2010stratified safety analyses were used with the large antidepressant data set; whereas, propensity score matched safety analyses were used with the smaller antiepileptic drug data because stratification was not feasible. In each case, mixed\u2010effects survival models compared the safety of participants when receiving the respective class of medication to periods when they did not receive that medication. When participants were more severely ill, they were significantly more likely to receive either class of psychotropics. Propensity quintile\u2010stratified safety analyses found that risk of suicide attempts or suicides was significantly reduced when participants received antidepressants. In contrast, propensity score matched safety analyses found neither significant risk nor protection from suicidality among participants receiving antiepileptics. Copyright \u00a9 2012 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/sim.5339","type":"journal-article","created":{"date-parts":[[2012,8,3]],"date-time":"2012-08-03T18:47:39Z","timestamp":1344019659000},"page":"3255-3260","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Two propensity score\u2010based strategies for a three\u2010decade observational study: investigating psychotropic medications and suicide risk"],"prefix":"10.1002","volume":"31","author":[{"given":"Andrew C.","family":"Leon","sequence":"first","affiliation":[{"name":"Department of Psychiatry Weill Cornell Medical College  New York NY U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakan","family":"Demirtas","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, School of Public Health University of Illinois at Chicago  Chicago IL U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunshan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Weill Cornell Medical College  New York NY U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Hedeker","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, School of Public Health University of Illinois at Chicago  Chicago IL U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,8,3]]},"reference":[{"key":"e_1_2_4_2_1","unstructured":"United States Food and Drug Administration.Antidepressant use in children adolescents and young adults. 2007 Revisions to product labeling.http:\/\/www.fda.gov\/downloads\/Drugs\/DrugSafety\/InformationbyDrugClass\/UCM173233.pdf(Accessed September 18 2011)."},{"key":"e_1_2_4_3_1","unstructured":"United States Food and Drug Administration.Antiepileptic drugs and suicidality 2009.http:\/\/www.fda.gov\/CDER\/Drug\/infopage\/antiepileptics\/default.htm(Accessed September 18 2011)."},{"key":"e_1_2_4_4_1","unstructured":"United States Food and Drug Administration.Briefing document for Psychopharmacologic Drugs Advisory Committee December 13 2006. page 38.www.fda.gov\/ohrms\/dockets\/ac\/06\/briefing\/2006\u20104272b1\u201001\u2010FDA.pdf(Accessed September 2 2010)."},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70175-8"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1528-1157.2002.40001.x"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31815ca2a3"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v63n0602"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5618.2007.00408.x"},{"key":"e_1_2_4_10_1","unstructured":"United States Food and Drug Administration.Antiepileptic drugs and suicidality: Statistical review and evaluation. 2008.http:\/\/www.fda.gov\/ohrms\/dockets\/ac\/08\/briefing\/2008\u20104372b1\u201001\u2010FDA.pdfAccessed April 19 2011."},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v64n0915"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.10m06552"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2011.11060948"},{"key":"e_1_2_4_14_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.136.1.49"},{"key":"e_1_2_4_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/70.1.41"},{"key":"e_1_2_4_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2458"},{"key":"e_1_2_4_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/096228020000900206"},{"key":"e_1_2_4_18_1","volume-title":"SuperMix \u2010 A program for mixed\u2010effects regression models","author":"Hedeker D","year":"2008"},{"key":"e_1_2_4_19_1","first-page":"719","article-title":"Statistical aspects of the analysis of data from retrospective studies of disease","volume":"22","author":"Mantel N","year":"1959","journal-title":"Journal of the National Cancer Institute"},{"key":"e_1_2_4_20_1","doi-asserted-by":"publisher","DOI":"10.2307\/1390693"},{"key":"e_1_2_4_21_1","doi-asserted-by":"publisher","DOI":"10.1198\/016214504000000647"},{"key":"e_1_2_4_22_1","unstructured":"HansenBB KlopferSO.Optimal full matching and related designs via network flows.Tech. 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