Article Figures & Data
Figures
- Figure 1
Study design schematic.
Note: For a given analysis, all control time periods are equal to case periods in length, and all washout periods are the same duration.
Tables
- Table 1
Association Between Exposure to Oseltamivir or Influenza Alone and Suicide: Overall and Stratified by Individual Characteristics
Characteristic Oseltamivir Influenza Only Analysis A: 10-day equivalent periods Case, No. 253a 173a Exposed 24 17 Unexposed 229 156 Control, No. 949 647 Exposed 124 89 Unexposed 825 558 Overall, OR (95% CI) 0.64 (0.39–1.00)b 0.63 (0.34–1.08) Sex, OR (95% CI) Male 0.64 (0.31–1.32) 0.82 (0.36–1.86) Female 0.64 (0.34–1.05) 0.52 (0.25–1.07) Age-group, OR (95% CI) 1–11 y 0.50 (0.11–2.27) 0.40 (0.04–3.69) 12–18 y 0.66 (0.41–1.04) 0.65 (0.37–1.12) Mental health history, OR (95% CI) No 0.62 (0.35–1.08) 0.51 (0.26–1.00) Yes 0.68 (0.33–1.42) 0.99 (0.39–2.45) History of suicide attempt, OR (95% CI) No 0.62 (0.39–0.99) 0.30 (0.04–2.38) Yes 0.91 (0.18–4.53) 0.67 (0.39–1.18) Influenza vaccine during season, OR (95% CI) No 0.71 (0.45–1.13) 0.60 (0.33–1.07) Yes 0.19 (0.03–1.46) 0.84 (0.22–3.19) Analysis B: 5-day case period, 10-day washout, 5-day control period Case, No. 253 173 Exposed 16 10 Unexposed 237 163 Control, No. 985 673 Exposed 74 74 Unexposed 911 599 Overall association, OR (95% CI) 0.82 (0.45–1.43) 0.48 (0.22–0.95)c Analysis C: 15-day equivalent periods Case, No. 253 173 Exposed 28 24 Unexposed 225 149 Control, No. 886 595 Exposed 150 96 Unexposed 736 499 Overall association, OR (95% CI) 0.57 (0.36–0.86)d 0.72 (0.43–1.15)
The Article in Brief
The Relationship Between Oseltamivir and Suicide in Pediatric Patients
James W. Antoon , and colleagues
Background Reports from the early 2000s raised concerns about the potential for psychiatric problems in children using oseltamivir. an antiviral drug used to treat influenza Type A and B. Previous research examining the association between oseltamivir exposure and neuropsychiatric issues (including suicide) in children have had mixed findings and were limited by small sample size, older data or potential confounding. This study examines the oseltamivir and suicide association using recent data and a study design that minimizes confounding.
What This Study Found Use of oseltamivir does not increase risk of suicide in children. Researchers identified 21,047 children between one and 18 years of age who attempted suicide during the 2009-2013 influenza seasons. Of those, 251 had been exposed to oseltamivir. Mean age was approximately 15 years, and underlying mental health diagnoses were common (65 percent). Because the observed association between oseltamivir and suicide could potentially be confounded by underlying influenza infection, the analysis was repeated with influenza diagnosis alone (without oseltamivir use) as the exposure. Using this novel study design, which reduced statistical concerns found in previous studies, researchers did not find an association between oseltamivir or influenza diagnosis (only) and suicide.
