Table 2.
Crude and adjusted hazard rate ratios (HRR) of treatment and safety outcomes comparing users of SSRI monotherapy with users of SSRIs in combination with NSAIDs or paracetamol
| Outcome | SSRI | SSRI & NSAID | SSRI & paracetamol |
|---|---|---|---|
| Treatment Outcomes | |||
| Contacts with depression | |||
| Events | 2966 | 224 | 74 |
| Person-years | 46,136.5 | 4612.4 | 2400.7 |
| Crude HRR (95%-CI) | 1.0 | 1.16 (1.00; 1.34) | 0.56 (0.43; 0.73) |
| Adjusted HRR1 (95%-CI) | 1.0 | 1.31 (1.11; 1.55) | 0.52 (0.37; 0.74) |
| Psychiatric Contacts | |||
| Events | 5823 | 398 | 129 |
| Person-years | 42,710.5 | 4602.7 | 2397.1 |
| Crude HRR (95%-CI) | 1.0 | 1.11 (0.99; 1.24) | 0.72 (0.59; 0.88) |
| Adjusted HRR1 (95%-CI) | 1.0 | 1.22 (1.07; 1.38) | 0.56 (0.44; 0.71) |
| Suicide attempts | |||
| Events | 837 | 40 | 10 |
| Person-years | 44,900.8 | 4624.8 | 2404.4 |
| Crude HRR (95%-CI) | 1.0 | 0.97 (0.70; 1.36) | 0.48 (0.23; 0.98) |
| Adjusted HRR1 (95%-CI) | 1.0 | 0.98 (0.69; 1.41) | 0.43 (0.20; 0.92) |
| Committed suicide | |||
| Events | 63 | 8 | Too few events |
| Person-years | 45,448.3 | 4625.6 | - |
| Crude HRR (95%-CI) | 1.0 | 1.34 (0.63; 2.85) | - |
| Adjusted HRR1 (95%-CI) | 1.0 | 0.85 (0.29; 2.50) | - |
| Safety Outcomes | |||
| All-cause mortality | |||
| Events | 1734 | 492 | 978 |
| Person-years | 45,174.5 | 4588.5 | 2339.4 |
| Crude HRR (95%-CI) | 1.0 | 1.03 (0.93; 1.14) | 3.69 (3.38; 4.02) |
| Adjusted HRR1 (95%-CI) | 1.0 | 1.02 (0.89; 1.17) | 3.18 (2.83; 3.58) |
| CVD mortality | |||
| Events | 508 | 182 | 280 |
| Person-years | 44,079.4 | 5595.3 | 3581.1 |
| Crude HRR (95%-CI) | 1.0 | 1.22 (1.04; 1.44) | 2.56 (2.20; 2.97) |
| Adjusted HRR1 (95%-CI) | 1.0 | 0.99 (0.75; 1.31) | 2.51 (1.93; 3.28) |
| GI mortality | |||
| Events | 67 | 34 | 37 |
| Person-years | 48,186.2 | 5764.5 | 3931.7 |
| Crude HRR (95%-CI) | 1.0 | 1.48 (0.96; 2.28) | 3.03 (2.02; 4.54) |
| Adjusted HRR1 (95%-CI) | 1.0 | 1.79 (0.97; 3.31) | 2.16 (1.16; 4.00) |
| CVD Contacts | |||
| Events | 1982 | 507 | 230 |
| Person-Years | 44,952.8 | 4579.9 | 3586.0 |
| Crude HRR (95%-CI) | 1.0 | 1.62 (1.46; 1.81) | 1.05 (0.91; 1.21) |
| Adjusted HRR1 (95%-CI) | 1.0 | 1.46 (1.18; 1.67) | 1.01 (0.84; 1.21) |
| GI Contacts | |||
| Events | 1523 | 187 | 143 |
| Person-Years | 43,531.8 | 4613.5 | 2683.5 |
| Crude HRR (95%-CI) | 1.0 | 0.84 (0.71; 0.98) | 0.76 (0.60; 0.96) |
| Adjusted HRR1 (95%-CI) | 1.0 | 0.82 (0.68; 0.99) | 1.02 (0.85; 1.22) |
Abbreviations and explanations: HRR = Hazard rate ratio; 95%-CI = 95% confidence interval; NSAID = nonsteroidal anti-inflammatory drug; SSRI = Selective serotonin reuptake inhibitor; Bold numbers represent statistically significant results.
1
The results are adjusted for: Age; gender; educational level; previous contacts with psychiatric and somatic disorders; Charlson Index score; prior use of NSAIDs, paracetamol, other anti-inflammatory and GI-protective drugs within the preceding year to index date; SSRI start year, and earlier suicide attempts.