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Suicidal ideation during treatment of depression with escitalopram and nortriptyline in genome-based therapeutic drugs for depression (GENDEP): a clinical trial
Suicidal thoughts and behaviours during antidepressant treatment, especially during the first weeks of treatment, have prompted warnings by regulatory bodies. The aim of the present study is to investigate the course and predictors of emergence and worsening of suicidal ideation during tricyclic ant...
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Published in: | BMC medicine 2009-10, Vol.7 (1), p.60-60, Article 60 |
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creator | Perroud, Nader Uher, Rudolf Marusic, Andrej Rietschel, Marcella Mors, Ole Henigsberg, Neven Hauser, Joanna Maier, Wolfgang Souery, Daniel Placentino, Anna Szczepankiewicz, Aleksandra Jorgensen, Lisbeth Strohmaier, Jana Zobel, Astrid Giovannini, Caterina Elkin, Amanda Gunasinghe, Cerisse Gray, Joanna Campbell, Desmond Gupta, Bhanu Farmer, Anne E McGuffin, Peter Aitchison, Katherine J |
description | Suicidal thoughts and behaviours during antidepressant treatment, especially during the first weeks of treatment, have prompted warnings by regulatory bodies. The aim of the present study is to investigate the course and predictors of emergence and worsening of suicidal ideation during tricyclic antidepressant and serotonin reuptake inhibitor treatment.
In a multicentre part-randomised open-label study, 811 adult patients with moderate to severe unipolar depression were allocated to flexible dosage of escitalopram or nortriptyline for 12 weeks. The suicidality items of three standard measures were integrated in a suicidal ideation score. Increases in this score were classified as treatment emergent suicidal ideation (TESI) or treatment worsening suicidal ideation (TWOSI) according to the absence or presence of suicidal ideation at baseline.
Suicidal ideation decreased during antidepressant treatment. Rates of TESI and TWOSI peaked in the fifth week. Severity of depression predicted TESI and TWOSI. In men, nortriptyline was associated with a 9.8-fold and 2.4-fold increase in TESI and TWOSI compared to escitalopram, respectively. Retirement and history of suicide attempts predicted TWOSI.
Increases in suicidal ideation were associated with depression severity and decreased during antidepressant treatment. In men, treatment with escitalopram is associated with lower risk of suicidal ideation compared to nortriptyline. Clinicians should remain alert to suicidal ideation beyond the initial weeks of antidepressant treatment.
EudraCT (No.2004-001723-38) and ISRCTN (No. 03693000). |
doi_str_mv | 10.1186/1741-7015-7-60 |
format | article |
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In a multicentre part-randomised open-label study, 811 adult patients with moderate to severe unipolar depression were allocated to flexible dosage of escitalopram or nortriptyline for 12 weeks. The suicidality items of three standard measures were integrated in a suicidal ideation score. Increases in this score were classified as treatment emergent suicidal ideation (TESI) or treatment worsening suicidal ideation (TWOSI) according to the absence or presence of suicidal ideation at baseline.
Suicidal ideation decreased during antidepressant treatment. Rates of TESI and TWOSI peaked in the fifth week. Severity of depression predicted TESI and TWOSI. In men, nortriptyline was associated with a 9.8-fold and 2.4-fold increase in TESI and TWOSI compared to escitalopram, respectively. Retirement and history of suicide attempts predicted TWOSI.
Increases in suicidal ideation were associated with depression severity and decreased during antidepressant treatment. In men, treatment with escitalopram is associated with lower risk of suicidal ideation compared to nortriptyline. Clinicians should remain alert to suicidal ideation beyond the initial weeks of antidepressant treatment.
EudraCT (No.2004-001723-38) and ISRCTN (No. 03693000).</description><identifier>ISSN: 1741-7015</identifier><identifier>EISSN: 1741-7015</identifier><identifier>DOI: 10.1186/1741-7015-7-60</identifier><identifier>PMID: 19832967</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Acquisitions & mergers ; Adolescent ; Adult ; Aged ; Antidepressants ; Antidepressive Agents, Tricyclic - adverse effects ; Antidepressive Agents, Tricyclic - therapeutic use ; Biomedical research ; Citalopram - adverse effects ; Citalopram - therapeutic use ; Clinical trials ; Complications and side effects ; Data collection ; Depression, Mental ; Depressive Disorder - drug therapy ; Dosage and administration ; Drug therapy ; Female ; Gender differences ; Genomes ; Hospitals ; Humans ; Male ; Management ; Medical research ; Mental health ; Middle Aged ; Nortriptyline ; Nortriptyline - adverse effects ; Nortriptyline - therapeutic use ; Personality Inventory ; Risk factors ; Serotonin Uptake Inhibitors - adverse effects ; Serotonin Uptake Inhibitors - therapeutic use ; Suicidal ideation ; Suicide - statistics & numerical data ; Suicides & suicide attempts ; Young Adult</subject><ispartof>BMC medicine, 2009-10, Vol.7 (1), p.60-60, Article 60</ispartof><rights>COPYRIGHT 2009 BioMed Central Ltd.</rights><rights>2009 Perroud et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2009 Perroud et al; licensee BioMed Central Ltd. 2009 Perroud et al; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b579t-a430de854d07b00bf78b60eeaf03f3246777b31d39642bcc7819a06b6ac45a6f3</citedby><cites>FETCH-LOGICAL-b579t-a430de854d07b00bf78b60eeaf03f3246777b31d39642bcc7819a06b6ac45a6f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768737/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/902280968?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19832967$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Perroud, Nader</creatorcontrib><creatorcontrib>Uher, Rudolf</creatorcontrib><creatorcontrib>Marusic, Andrej</creatorcontrib><creatorcontrib>Rietschel, Marcella</creatorcontrib><creatorcontrib>Mors, Ole</creatorcontrib><creatorcontrib>Henigsberg, Neven</creatorcontrib><creatorcontrib>Hauser, Joanna</creatorcontrib><creatorcontrib>Maier, Wolfgang</creatorcontrib><creatorcontrib>Souery, Daniel</creatorcontrib><creatorcontrib>Placentino, Anna</creatorcontrib><creatorcontrib>Szczepankiewicz, Aleksandra</creatorcontrib><creatorcontrib>Jorgensen, Lisbeth</creatorcontrib><creatorcontrib>Strohmaier, Jana</creatorcontrib><creatorcontrib>Zobel, Astrid</creatorcontrib><creatorcontrib>Giovannini, Caterina</creatorcontrib><creatorcontrib>Elkin, Amanda</creatorcontrib><creatorcontrib>Gunasinghe, Cerisse</creatorcontrib><creatorcontrib>Gray, Joanna</creatorcontrib><creatorcontrib>Campbell, Desmond</creatorcontrib><creatorcontrib>Gupta, Bhanu</creatorcontrib><creatorcontrib>Farmer, Anne E</creatorcontrib><creatorcontrib>McGuffin, Peter</creatorcontrib><creatorcontrib>Aitchison, Katherine J</creatorcontrib><title>Suicidal ideation during treatment of depression with escitalopram and nortriptyline in genome-based therapeutic drugs for depression (GENDEP): a clinical trial</title><title>BMC medicine</title><addtitle>BMC Med</addtitle><description>Suicidal thoughts and behaviours during antidepressant treatment, especially during the first weeks of treatment, have prompted warnings by regulatory bodies. The aim of the present study is to investigate the course and predictors of emergence and worsening of suicidal ideation during tricyclic antidepressant and serotonin reuptake inhibitor treatment.
In a multicentre part-randomised open-label study, 811 adult patients with moderate to severe unipolar depression were allocated to flexible dosage of escitalopram or nortriptyline for 12 weeks. The suicidality items of three standard measures were integrated in a suicidal ideation score. Increases in this score were classified as treatment emergent suicidal ideation (TESI) or treatment worsening suicidal ideation (TWOSI) according to the absence or presence of suicidal ideation at baseline.
Suicidal ideation decreased during antidepressant treatment. Rates of TESI and TWOSI peaked in the fifth week. Severity of depression predicted TESI and TWOSI. In men, nortriptyline was associated with a 9.8-fold and 2.4-fold increase in TESI and TWOSI compared to escitalopram, respectively. Retirement and history of suicide attempts predicted TWOSI.
Increases in suicidal ideation were associated with depression severity and decreased during antidepressant treatment. In men, treatment with escitalopram is associated with lower risk of suicidal ideation compared to nortriptyline. Clinicians should remain alert to suicidal ideation beyond the initial weeks of antidepressant treatment.
EudraCT (No.2004-001723-38) and ISRCTN (No. 03693000).</description><subject>Acquisitions & mergers</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Antidepressants</subject><subject>Antidepressive Agents, Tricyclic - adverse effects</subject><subject>Antidepressive Agents, Tricyclic - therapeutic use</subject><subject>Biomedical research</subject><subject>Citalopram - adverse effects</subject><subject>Citalopram - therapeutic use</subject><subject>Clinical trials</subject><subject>Complications and side effects</subject><subject>Data collection</subject><subject>Depression, Mental</subject><subject>Depressive Disorder - drug therapy</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Gender differences</subject><subject>Genomes</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Management</subject><subject>Medical research</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Nortriptyline</subject><subject>Nortriptyline - adverse effects</subject><subject>Nortriptyline - therapeutic use</subject><subject>Personality Inventory</subject><subject>Risk factors</subject><subject>Serotonin Uptake Inhibitors - adverse effects</subject><subject>Serotonin Uptake Inhibitors - therapeutic use</subject><subject>Suicidal ideation</subject><subject>Suicide - statistics & numerical data</subject><subject>Suicides & suicide attempts</subject><subject>Young Adult</subject><issn>1741-7015</issn><issn>1741-7015</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kk1v1DAQhiMEoqVw5YgsTnBIsZ3ETjggrcpSKlWABJwtf4yzXiV2sBNQ_w0_FS-7ardCyAfb844fvZ6ZonhO8DkhLXtDeE1KjklT8pLhB8XpbeDh0fmkeJLSFmPacF4_Lk5I11a0Y_y0-P11cdoZOSBnQM4ueGSW6HyP5pjvI_gZBYsMTBFS2sm_3LxBkLSb5RCmKEckvUE-xDm6ab4ZnAfkPOrBhxFKJRMYNG8gygmW2Wlk4tInZEM8hr66XH96v_7y-i2SSGeE09lRBsrhafHIyiHBs8N-Vnz_sP528bG8_nx5dbG6LlXDu7mUdYUNtE1tMFcYK8tbxTCAtLiyFa0Z51xVxFQdq6nSmrekk5gpJnXdSGars-JqzzVBbsUU3SjjjQjSib-BEHshY_Y_gLCMMUpoRyXwWratIp2mtoO6UhabhmXWuz1rWtQIRuciRjncg95XvNuIPvwUlLOWVzwDVnuAcuE_gPuKDqPYdVvsui24YDgzXh5MxPBjgTSLbViizzUUHaa0xR1rc9L5PqmX-WPO25BxOi8Do9PBg3U5vqIEM1I1jN090DGkFMHemiJY7CbyXxsvjmtxl34YweoPwd3ffw</recordid><startdate>20091015</startdate><enddate>20091015</enddate><creator>Perroud, Nader</creator><creator>Uher, Rudolf</creator><creator>Marusic, Andrej</creator><creator>Rietschel, Marcella</creator><creator>Mors, Ole</creator><creator>Henigsberg, Neven</creator><creator>Hauser, Joanna</creator><creator>Maier, Wolfgang</creator><creator>Souery, Daniel</creator><creator>Placentino, Anna</creator><creator>Szczepankiewicz, Aleksandra</creator><creator>Jorgensen, Lisbeth</creator><creator>Strohmaier, Jana</creator><creator>Zobel, Astrid</creator><creator>Giovannini, Caterina</creator><creator>Elkin, Amanda</creator><creator>Gunasinghe, Cerisse</creator><creator>Gray, Joanna</creator><creator>Campbell, Desmond</creator><creator>Gupta, Bhanu</creator><creator>Farmer, Anne E</creator><creator>McGuffin, Peter</creator><creator>Aitchison, Katherine J</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20091015</creationdate><title>Suicidal ideation during treatment of depression with escitalopram and nortriptyline in genome-based therapeutic drugs for depression (GENDEP): a clinical trial</title><author>Perroud, Nader ; Uher, Rudolf ; Marusic, Andrej ; Rietschel, Marcella ; Mors, Ole ; Henigsberg, Neven ; Hauser, Joanna ; Maier, Wolfgang ; Souery, Daniel ; Placentino, Anna ; Szczepankiewicz, Aleksandra ; Jorgensen, Lisbeth ; Strohmaier, Jana ; Zobel, Astrid ; Giovannini, Caterina ; Elkin, Amanda ; Gunasinghe, Cerisse ; Gray, Joanna ; Campbell, Desmond ; Gupta, Bhanu ; Farmer, Anne E ; McGuffin, Peter ; Aitchison, Katherine J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b579t-a430de854d07b00bf78b60eeaf03f3246777b31d39642bcc7819a06b6ac45a6f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acquisitions & mergers</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Antidepressants</topic><topic>Antidepressive Agents, Tricyclic - 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The aim of the present study is to investigate the course and predictors of emergence and worsening of suicidal ideation during tricyclic antidepressant and serotonin reuptake inhibitor treatment.
In a multicentre part-randomised open-label study, 811 adult patients with moderate to severe unipolar depression were allocated to flexible dosage of escitalopram or nortriptyline for 12 weeks. The suicidality items of three standard measures were integrated in a suicidal ideation score. Increases in this score were classified as treatment emergent suicidal ideation (TESI) or treatment worsening suicidal ideation (TWOSI) according to the absence or presence of suicidal ideation at baseline.
Suicidal ideation decreased during antidepressant treatment. Rates of TESI and TWOSI peaked in the fifth week. Severity of depression predicted TESI and TWOSI. In men, nortriptyline was associated with a 9.8-fold and 2.4-fold increase in TESI and TWOSI compared to escitalopram, respectively. Retirement and history of suicide attempts predicted TWOSI.
Increases in suicidal ideation were associated with depression severity and decreased during antidepressant treatment. In men, treatment with escitalopram is associated with lower risk of suicidal ideation compared to nortriptyline. Clinicians should remain alert to suicidal ideation beyond the initial weeks of antidepressant treatment.
EudraCT (No.2004-001723-38) and ISRCTN (No. 03693000).</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>19832967</pmid><doi>10.1186/1741-7015-7-60</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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source | Access via ProQuest (Open Access); PubMed Central |
subjects | Acquisitions & mergers Adolescent Adult Aged Antidepressants Antidepressive Agents, Tricyclic - adverse effects Antidepressive Agents, Tricyclic - therapeutic use Biomedical research Citalopram - adverse effects Citalopram - therapeutic use Clinical trials Complications and side effects Data collection Depression, Mental Depressive Disorder - drug therapy Dosage and administration Drug therapy Female Gender differences Genomes Hospitals Humans Male Management Medical research Mental health Middle Aged Nortriptyline Nortriptyline - adverse effects Nortriptyline - therapeutic use Personality Inventory Risk factors Serotonin Uptake Inhibitors - adverse effects Serotonin Uptake Inhibitors - therapeutic use Suicidal ideation Suicide - statistics & numerical data Suicides & suicide attempts Young Adult |
title | Suicidal ideation during treatment of depression with escitalopram and nortriptyline in genome-based therapeutic drugs for depression (GENDEP): a clinical trial |
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