Zolpidem Use and Suicide Death in South Korea: A Population-Based Case–Control Study
BongKyoo Choi ScD
Department of Medicine and Program in Public Health, University of California, Irvine, Irvine, CA, USA
Search for more papers by this authorHi Gin Sung PhD
School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
Search for more papers by this authorJin Hyun Nam PhD
School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
Search for more papers by this authorCorresponding Author
Ju-Young Shin PhD
School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
Address correspondence to Ju-Young Shin, School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeong gi-do, South Korea; E-mail: [email protected]Search for more papers by this authorBongKyoo Choi ScD
Department of Medicine and Program in Public Health, University of California, Irvine, Irvine, CA, USA
Search for more papers by this authorHi Gin Sung PhD
School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
Search for more papers by this authorJin Hyun Nam PhD
School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
Search for more papers by this authorCorresponding Author
Ju-Young Shin PhD
School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
Address correspondence to Ju-Young Shin, School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon, Gyeong gi-do, South Korea; E-mail: [email protected]Search for more papers by this authorAbstract
Objective
To investigate whether zolpidem use is associated with suicide death in adults.
Method
We conducted a case–control study using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) database. Cases were adults with a suicide record (ICD-10 codes; X-60-X84, Y87.0) between January 1, 2004 and December 31, 2013. 10 Controls were matched to each case by age, sex, index year, region, income level, and health insurance type. Zolpidem use during 2 years before suicide was quantified. Adjusted odd ratios (aORs) with 95% confidence intervals (CIs) were estimated using conditional logistic regression.
Results
The percentage of zolpidem users was significantly higher in cases (451 of 1,928 [23.4%]) than in controls (832 of 18,404 [4.5%]). After controlling for potential confounders, zolpidem use was significantly associated with suicide (aORs, 2.09; 95% CI, 1.74–2.52). Dose–response relationships were observed (for trend, p < .0001). Consistent findings were observed when analyses were restricted to suicide death (aORs, 2.08; 95% CI, 1.73–2.51) and nonmedication poisoning suicide death cases (aORs, 2.10; 95% CI, 1.74–2.53).
Conclusions
We found a significant and positive association between zolpidem use and suicide. Zolpidem should be prescribed cautiously and with due caution of increased suicide risk.
Supporting Information
| Filename | Description |
|---|---|
| sltb12548-sup-0001-TableS1-S3.docWord document, 128 KB |
Table S1. Sensitivity analysis of the association between zolpidem and suicide, with variable time windows. Table S2. Sensitivity analysis of the association between zolpidem and suicide death, excluding cases of attempted suicide in individuals with zolpidem exposure. Table S3. Sensitivity analysis of the association between zolpidem and suicide death, except by poisoning using drugs, medicaments, and biological substances (T36–T50) in individuals with zolpidem exposure odds ratio for the risk of suicide in individuals with zolpidem exposure |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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