Emulating a randomized clinical trial with real-world data to evaluate the effect of antidepressant use in PTSD patients with high suicide risk
IntroductionPost-Traumatic Stress Disorder (PTSD) entails behavioral changes with increased risk of suicide, and there is no consensus on the preferred antidepressants for treatment of those PTSD patients who are at elevated risk for suicide.MethodsWe conducted a clinical trial emulation study compa...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1526488/full |
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| author | Oshin Miranda Xiguang Qi M. Daniel Brannock Ryan Whitworth Thomas Kosten Neal David Ryan Gretchen L. Haas Gretchen L. Haas Gretchen L. Haas Levent Kirisci LiRong Wang |
| author_facet | Oshin Miranda Xiguang Qi M. Daniel Brannock Ryan Whitworth Thomas Kosten Neal David Ryan Gretchen L. Haas Gretchen L. Haas Gretchen L. Haas Levent Kirisci LiRong Wang |
| author_sort | Oshin Miranda |
| collection | DOAJ |
| description | IntroductionPost-Traumatic Stress Disorder (PTSD) entails behavioral changes with increased risk of suicide, and there is no consensus on the preferred antidepressants for treatment of those PTSD patients who are at elevated risk for suicide.MethodsWe conducted a clinical trial emulation study comparing suicide-related events (SREs) among those patients’ initiating antidepressants within 60 days after a qualifying SRE. Patients were followed from initiation of antidepressant until any of the following: treatment cessation, switching, death, or loss to follow-up. The outcome is a new onset of an SRE.ResultsCitalopram exhibited a significantly fewer case with new SREs compared to other most used antidepressants such as venlafaxine, duloxetine, and mirtazapine–even after adjusting for multiple comparisons and other covariants.DiscussionFindings suggest potential risks associated with certain antidepressants in the PTSD population, emphasizing cautious prescription considerations. |
| format | Article |
| id | doaj-art-b71ccfa05959465789661cd526110e96 |
| institution | Kabale University |
| issn | 1664-0640 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj-art-b71ccfa05959465789661cd526110e962025-01-28T11:37:16ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-01-011510.3389/fpsyt.2024.15264881526488Emulating a randomized clinical trial with real-world data to evaluate the effect of antidepressant use in PTSD patients with high suicide riskOshin Miranda0Xiguang Qi1M. Daniel Brannock2Ryan Whitworth3Thomas Kosten4Neal David Ryan5Gretchen L. Haas6Gretchen L. Haas7Gretchen L. Haas8Levent Kirisci9LiRong Wang10Department of Pharmaceutical Sciences/School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Pharmaceutical Sciences/School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United StatesRTI International, Durham, NC, United StatesRTI International, Durham, NC, United StatesMenninger Department of Psychiatry, Baylor College of Medicine, Houston, TX, United StatesDepartment of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Psychology, Dietrich School of Arts and Sciences, University of Pittsburgh, Pittsburgh, PA, United StatesVISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, PA, United StatesDepartment of Pharmaceutical Sciences/School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Pharmaceutical Sciences/School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, United StatesIntroductionPost-Traumatic Stress Disorder (PTSD) entails behavioral changes with increased risk of suicide, and there is no consensus on the preferred antidepressants for treatment of those PTSD patients who are at elevated risk for suicide.MethodsWe conducted a clinical trial emulation study comparing suicide-related events (SREs) among those patients’ initiating antidepressants within 60 days after a qualifying SRE. Patients were followed from initiation of antidepressant until any of the following: treatment cessation, switching, death, or loss to follow-up. The outcome is a new onset of an SRE.ResultsCitalopram exhibited a significantly fewer case with new SREs compared to other most used antidepressants such as venlafaxine, duloxetine, and mirtazapine–even after adjusting for multiple comparisons and other covariants.DiscussionFindings suggest potential risks associated with certain antidepressants in the PTSD population, emphasizing cautious prescription considerations.https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1526488/fullsocial determinants of healthpost-tramatic stress disordersuicide-related behaviorantidepressantclinical trial emulation |
| spellingShingle | Oshin Miranda Xiguang Qi M. Daniel Brannock Ryan Whitworth Thomas Kosten Neal David Ryan Gretchen L. Haas Gretchen L. Haas Gretchen L. Haas Levent Kirisci LiRong Wang Emulating a randomized clinical trial with real-world data to evaluate the effect of antidepressant use in PTSD patients with high suicide risk Frontiers in Psychiatry social determinants of health post-tramatic stress disorder suicide-related behavior antidepressant clinical trial emulation |
| title | Emulating a randomized clinical trial with real-world data to evaluate the effect of antidepressant use in PTSD patients with high suicide risk |
| title_full | Emulating a randomized clinical trial with real-world data to evaluate the effect of antidepressant use in PTSD patients with high suicide risk |
| title_fullStr | Emulating a randomized clinical trial with real-world data to evaluate the effect of antidepressant use in PTSD patients with high suicide risk |
| title_full_unstemmed | Emulating a randomized clinical trial with real-world data to evaluate the effect of antidepressant use in PTSD patients with high suicide risk |
| title_short | Emulating a randomized clinical trial with real-world data to evaluate the effect of antidepressant use in PTSD patients with high suicide risk |
| title_sort | emulating a randomized clinical trial with real world data to evaluate the effect of antidepressant use in ptsd patients with high suicide risk |
| topic | social determinants of health post-tramatic stress disorder suicide-related behavior antidepressant clinical trial emulation |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1526488/full |
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