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Although studies have shown increased risks for suicidal ideation and attempts with selective serotonin reuptake inhibitors (SSRIs) in patients aged ≤24, the effect of dose on these risks has not been examined. Now, researchers have compared risks for deliberate self-harm after initiation of citalopram, fluoxetine, or sertraline for depression at high versus modal dose. Analyses were based on observational data on 162,625 patients (age range, 10–64) from a large claims database.
High- and modal-dose groups were propensity-matched on multiple demographic, illness severity, and suicide history variables. Patients changing doses were censored from analyses. Among patients aged ≤24 or younger, subsequent risk for self-harm was twice as great in …