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Suicide risk raised with venlafaxine

Patients using venlafaxine are significantly more likely to commit suicide than those on other antidepressants, a study of UK general practice shows.

The research, covering more than 200,000 patients, found use of venlafaxine was 'consistently associated with higher risk of suicide' than citalopram, fluoxetine and dothiepin.

The analysis was unusual in examining completed suicides, rather than simply suicidal behaviour, using information on the UK general practice research database.

It found venlafaxine increased risk of suicide 2.44-fold compared with citalopram, 2.85-fold compared with fluoxetine and 2.54-fold compared with dothiepin.

But the study, which informed a recent evaluation by the Commission on Human Medicines, found the increased risks fell substantially after adjustment for confounders, and ceased to be significant.

The researchers, whose study was published online by the BMJ, suggested the increase in risks might have been further reduced or eliminated if they had been able to control for other factors.

Study leader Dr Elizabeth Andrews, vice president in pharmacoepidemiology and risk management at independent analysts RTI Health Solutions, said venlafaxine was prescribed to patients who were 'more severely ill' than those on other drugs.

Dr George Rae, member of the GPC prescribing subcommittee, said there was 'no cavalier prescribing' of venlafaxine, but that the research 'should be taken on board'.

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