{"id":47506,"date":"2014-06-19T20:00:23","date_gmt":"2014-06-20T00:00:23","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=47506"},"modified":"2014-06-19T20:10:37","modified_gmt":"2014-06-20T00:10:37","slug":"a-madness-to-our-method","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2014\/06\/19\/a-madness-to-our-method\/","title":{"rendered":"a madness to our method…"},"content":{"rendered":"
\n
Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study<\/a><\/div>\n
by Christine Y Lu, Fang Zhang, Matthew D Lakoma, Jeanne M Madden, Donna Rusinak, Robert B Penfold, Gregory Simon, Brian K Ahmedani, Gregory Clarke, Enid M Hunkeler, Beth Waitzfelder, Ashli Owen-Smith, Marsha A Raebel, Rebecca Rossom, Karen J Coleman, Laurel A Copeland, and Stephen B Soumerai<\/div>\n
British Medical Journal<\/font><\/strong>. 2014 348:g3596.<\/div>\n
[full text on-line<\/a>]<\/div>\n

<\/p>\n

Objective<\/font><\/strong><\/u> To investigate if the widely publicized warnings in 2003 from the US Food and Drug Administration about a possible increased risk of suicidality with antidepressant use in young people were associated with changes in antidepressant use, suicide attempts, and completed suicides among young people.<\/div>\n
Design<\/font><\/strong><\/u> Quasi-experimental study assessing changes in outcomes after the warnings, controlling for pre-existing trends.<\/div>\n
Setting<\/font><\/strong><\/u> Automated healthcare claims data [2000-10] derived from the virtual data warehouse of 11 health plans in the US Mental Health Research Network.<\/div>\n
Participants<\/font><\/strong><\/u> Study cohorts included adolescents [around 1.1 million], young adults [around 1.4 million], and adults [around 5 million].<\/div>\n
Main outcome measures<\/font><\/strong><\/u> Rates of antidepressant dispensings, psychotropic drug poisonings [a validated proxy for suicide attempts], and completed suicides.<\/div>\n
Results<\/font><\/strong><\/u> Trends in antidepressant use and poisonings changed abruptly after the warnings. In the second year after the warnings, relative changes in antidepressant use were −31.0% [95% confidence interval −33.0% to −29.0%] among adolescents, −24.3% [−25.4% to −23.2%] among young adults, and −14.5% [−16.0% to −12.9%] among adults. These reflected absolute reductions of 696, 1216, and 1621 dispensings per 100 000 people among adolescents, young adults, and adults, respectively. Simultaneously, there were significant, relative increases in psychotropic drug poisonings in adolescents [21.7%, 95% confidence interval 4.9% to 38.5%] and young adults [33.7%, 26.9% to 40.4%] but not among adults [5.2%, −6.5% to 16.9%]. These reflected absolute increases of 2 and 4 poisonings per 100 000 people among adolescents and young adults, respectively [approximately 77 additional poisonings in our cohort of 2.5 million young people]. Completed suicides did not change for any age group.<\/div>\n
Conclusions<\/font><\/strong><\/u> Safety warnings about antidepressants and widespread media coverage decreased antidepressant use, and there were simultaneous increases in suicide attempts among young people. It is essential to monitor and reduce possible unintended consequences of FDA warnings and media reporting.<\/div>\n<\/blockquote>\n
<\/div>\n
I sippose that I would be predicted to react negatively to this article, described by some today as the most famous article on the planet<\/em> several hours after it went online. But to be honest, I spent the afternoon reading and rereading the Methods section to no avail. It actually reminded me of those opaque Gibbons articles [an anatomy of a deceit 1…<\/a> etc] two years ago. Even if it said what I would expect it to say, I wouldn’t believe it either without a major methodological explanation. For one thing, the suicide data from these HMOs is radically different in shape and magnitude from that in the CDC Compressed Mortality<\/font><\/strong><\/u><\/a> which goes back to 1979 [see peaks and valleys…<\/a>]:<\/div>\n
<\/div>\n
 <\/div>\n
Whatever the case, I expect there will be re-analyses all over the Internet by month’s end. So if you’re going to read this article, read the Methods<\/font><\/strong> section first and if you understand what they actually did, please enlighten the rest of us…<\/div>\n","protected":false},"excerpt":{"rendered":"

Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study by Christine Y Lu, Fang Zhang, Matthew D Lakoma, Jeanne M Madden, Donna Rusinak, Robert B Penfold, Gregory Simon, Brian K Ahmedani, Gregory Clarke, Enid M Hunkeler, Beth Waitzfelder, Ashli Owen-Smith, Marsha A Raebel, Rebecca Rossom, Karen […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-47506","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/47506","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=47506"}],"version-history":[{"count":9,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/47506\/revisions"}],"predecessor-version":[{"id":48234,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/47506\/revisions\/48234"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=47506"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=47506"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=47506"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}