ArticleSchizophrenia bulletin2021
Comparative Effectiveness of Antipsychotics for Risk of Attempted or Completed Suicide Among Persons With Schizophrenia.
Article in Schizophrenia bulletin, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 79 citations in OpenAlex.
- Glial Markers of Suicidal Behavior in the Human Brain-A Systematic Review of Postmortem Studies.International journal of molecular sciences · 2024Pooled it
- Electroconvulsive therapy: improved understanding of long-term risks and benefits from advances in administrative health data.The British journal of psychiatry : the journal of mental science · 2026Review
- Effect of psychotropic medications on suicide-related outcomes: a systematic review and meta-analysis of observational studies.EClinicalMedicine · 2026Article
- SUICIDE AND PSYCHOSIS: Comparing the Characteristics of Patients Who Died by Suicide Following Recent Onset and Longer Duration of Schizophrenia and Other Primary Psychotic Disorders, 2008-2021.Schizophrenia bulletin · 2026Article
- Real-world antipsychotic prescribing pathways and treatment modifications in schizophrenia spectrum disorders: evidence from the United Arab Emirates.Frontiers in pharmacology · 2026Article
- Methodologies Employed in Economic Evaluation of Suicide Prevention Interventions: A Scoping Review.Administration and policy in mental health · 2026Article
- Evaluating the adverse drug reactions to clozapine in populations of children and adolescents: insights from VigiBase data.European child & adolescent psychiatry · 2025Article
- Efficacy and tolerability of pharmacological interventions for schizophrenia non-responsive to prior treatment: a systematic review and network meta-analysis.EClinicalMedicine · 2025Article
- Anti-Suicidal Effects of Lithium, Ketamine, and Clozapine-A 10-Year Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Molecular, physiological and functional features underlying antipsychotic medication use related cortical thinning.Translational psychiatry · 2025Article
- An exploratory study evaluating the 20 medications most commonly associated with suicidal ideation and self-injurious behavior in the FAERS database.BMC pharmacology & toxicology · 2025Article
- Clozapine as a Long-Term Therapeutic Choice: Longitudinal Analysis of Schizophrenia Symptoms in a Naturalistic Setting.Schizophrenia bulletin open · 2025Article
- Effect of psilocybin therapy on suicidal ideation, attempts, and deaths in people with psychiatric diagnoses: a systematic review and meta-analysis.Therapeutic advances in psychopharmacology · 2025Review
- Psychotropic Medications Promote Time-Dependent Reduction of Suicidal Ideation in Mood Disorder: A Prospective Cohort Study.Journal of Korean medical science · 2024Article
- History of suicidal behavior and clozapine prescribing among people with schizophrenia in China: a cohort study.BMC psychiatry · 2024Observational
- Real-world effectiveness of antidepressants, antipsychotics and their combinations in the maintenance treatment of psychotic depression. Evidence from within-subject analyses of two nationwide cohorts.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2024Article
- Suicide in young people: screening, risk assessment, and intervention.BMJ (Clinical research ed.) · 2023Review
- Pharmacokinetics and pharmacogenomics of clozapine in an ancestrally diverse sample: a longitudinal analysis and genome-wide association study using UK clinical monitoring data.The lancet. Psychiatry · 2023Article
- Cost-effectiveness of implementing a suicide prediction tool (OxMIS) in severe mental illness: Economic modeling study.European psychiatry : the journal of the Association of European Psychiatrists · 2022Article
- Associations between antipsychotics and risk of violent crimes and suicidal behaviour in personality disorder.Evidence-based mental health · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe objective of our study was to investigate the comparative effectiveness of antipsychotics for the risk of attempted or completed suicide among all patients with schizophrenia in Finland and Sweden.
methodsTwo nationwide register-based cohort studies were conducted, including all individuals with schizophrenia in Finland (n = 61 889) and Sweden (n=29 823). The main exposure was 10 most commonly used antipsychotic monotherapies; also, adjunctive pharmacotherapies were investigated. The main outcome measure was attempted or completed suicide, which was analyzed with within-individual models by comparing use and nonuse periods in the same individual to minimize selection bias. Sensitivity analyses included attempted suicide (hospitalization only) as an outcome.
resultsCompared with no use of antipsychotics, clozapine use was the only antipsychotic consistently associated with a decreased risk of suicidal outcomes. Hazard ratios (HRs) and 95% CIs for attempted or completed suicide were 0.64 (0.49-0.84) in the Finnish cohort and 0.66 (0.43-0.99) in the Swedish cohort. No other antipsychotic was associated with a reduced risk of attempted and/or completed suicide. Benzodiazepines and Z-drugs were associated with an increased risk of attempted or completed suicide (HRs: 1.29-1.30 for benzodiazepines and 1.33-1.62 for Z-drugs).
conclusionClozapine was the only antipsychotic associated with decreased risk of attempted or completed suicide among patients with schizophrenia, and it should be considered as first-line treatment for high-risk patients.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.