Suicidal ideation during treatment of XXXX with @entity837 and @entity5080 in genome-based therapeutic drugs for @entity308 (GENDEP): a clinical trial.

@entity1 @entity308 @entity5080 @entity837 @entity750 @entity1742
BACKGROUND: 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 @entity750 reuptake inhibitor treatment. METHODS: In a multicentre part-randomised open-label study, 811 adult @entity1 with moderate to severe @entity308 were allocated to flexible dosage of @entity837 or @entity5080 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 @entity1742 ( @entity1742 ) according to the absence or presence of suicidal ideation at baseline. RESULTS: Suicidal ideation decreased during antidepressant treatment. Rates of TESI and @entity1742 peaked in the fifth week. Severity of @entity308 predicted TESI and @entity1742 . In @entity1 , @entity5080 was associated with a 9.8-fold and 2.4-fold increase in TESI and @entity1742 compared to @entity837 , respectively. Retirement and history of suicide attempts predicted @entity1742 . CONCLUSION: Increases in suicidal ideation were associated with @entity308 severity and decreased during antidepressant treatment. In @entity1 , treatment with @entity837 is associated with lower risk of suicidal ideation compared to @entity5080 . Clinicians should remain alert to suicidal ideation beyond the initial weeks of antidepressant treatment. TRIAL REGISTRATION: EudraCT (No.2004-001723-38) and ISRCTN (No. 03693000).
