E-drug: Calcium channel blockers and suicide
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BMJ No 7133 Volume 316 7 March 1998
http://www.bmj.com/bmj/archive/7133/7133a.htm#3
Use of calcium channel blockers and risk of suicide: ecological findings
confirmed in population based cohort study
Gunnar Lindberg, Kerstin Bingefors, Jonas Ranstam, Lennart Rastam,
Arne Melander
Abstract
Objective: To investigate possible associations between use of
cardiovascular drugs and suicide.
Design: Cross sectional ecological study based on rates of use of eight
cardiovascular drug groups by outpatients. A population based cohort
study including users of drugs to control hypertension.
Subjects: The ecological study included 152 of Sweden's 284
municipalities. The cohort study included all inhabitants of one Swedish
municipality who during 1988 or 1989 had purchased cardiovascular
agents from pharmacies within the municipality. Six hundred and
seventeen subjects (18.2%) were classified as users of calcium channel
blockers and 2780 (81.8%) as non-users.
Main outcome measures: Partial correlations (least squares method)
between rates of use of cardiovascular drugs and age standardised
mortality from suicide in Swedish municipalities. Hazard ratios for risk
of suicide with adjustments for difference in age and sex in users of
calcium channel blockers compared with users of other hypertensive
drugs.
Results: Among the Swedish municipalities the use of each
cardiovascular drug group except angiotensin converting enzyme
inhibitors correlated significantly and positively with suicide rates.
After adjustment for the use of other cardiovascular drug groups, as a
substitute for the prevalence of cardiovascular morbidity, only the
correlation with calcium channel blockers remained significant (r=0.29,
P<0.001). In the cohort study, five users and four non-users of calcium
channel blockers committed suicide during the follow up until the end
of 1994. The absolute risk associated with use of calcium channel
blockers was 1.1 suicides per 1000 person years. The relative risk,
adjusted for differences in age and sex, among users versus non-users
was 5.4 (95% confidence interval 1.4 to 20.5).
Conclusions: Use of calcium channel blockers may increase the risk of
suicide.
Jerome Sclafer
La revue Prescrire BP 459 - 75527 Cedex 11 France
tel: +33 1 4700 9445 fax: +33 1 4807 8732
e-mail: jeromjet@easynet.fr
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