{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T22:51:37Z","timestamp":1767912697571,"version":"3.49.0"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Suicide &amp; Life Threat Behav"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Meta\u2010analyses show antidepressant initiation has increased risk of suicidal behavior &lt;25\u00a0years, no difference 25\u201364\u00a0years and reduced risk 65+ years. Estimating risks from RCTs has limitations and real\u2010world population estimates are uncommon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A self\u2010controlled case series reporting incidence rate ratio (IRR) between exposed and control periods for antidepressants associated with suicide attempt, in Australian older age adults. We included all cases with suicide attempt [hospital data for ICD codes (X60\u2013X84)] and any antidepressant use (<jats:italic>n<\/jats:italic>\u00a0=\u00a0689) by participants in the \u201c45 and Up Study\u201d.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For all antidepressants the IRR for suicide attempt was elevated across all exposures, declining from 7.44 (95%CI 5.57\u20139.94) during the first 30\u00a0days, to 2.21 (1.73\u20132.81) at 91+ days. All four antidepressant sub\u2010groups had higher IRRs for the first 30\u00a0day exposure: 2.43 (1.37\u20134.29) for TCAs, 4.06 (2.78\u20135.93) for SSRIs, 4.15 (2.65\u20136.50) for other antidepressants, and 4.92 (3.30\u20137.34) for SNRIs. Increased IRR persisted for 61\u2010 to 90\u2010day exposures for SSRIs 2.42 (1.18\u20134.98) and SNRIs 2.66 (1.34\u20135.27).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Some older adults have increased risk of suicide attempt with antidepressant exposure, which may persist for months. Clinical guidelines should recommend a period of monitoring for treatment\u2010emergent suicidal thoughts and behaviors in older adult patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/sltb.12812","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T08:00:31Z","timestamp":1635148831000},"page":"121-131","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Antidepressant treatment trajectories and suicide attempt among Australians aged 45 years and older: A population study using individual prescription data"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8180-1798","authenticated-orcid":false,"given":"Gregory","family":"Carter","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Science University of Newcastle Newcastle New South Wales 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