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Letters Varenicline and suicide

Authors’ reply

BMJ 2009; 339 doi: (Published 01 December 2009) Cite this as: BMJ 2009;339:b4969
  1. David Gunnell, professor of epidemiology1,
  2. David Irvine, pharmacoepidemiologist2,
  3. Lesley Wise, senior pharmacoepidemiologist2,
  4. Claire Davies, senior pharmacovigilance assessor2,
  5. Richard M Martin, professor of clinical epidemiology1
  1. 1University of Bristol, Department of Social Medicine, University of Bristol, Bristol BS8 2PS
  2. 2Vigilance and Risk Management of Medicines, Medicines and Healthcare products Regulatory Agency, London SW8 5NQ
  1. d.j.gunnell{at}

    Moore and Furberg highlight the difference between our findings and the strong signal of suicide risk for varenicline seen in yellow card reporting.1 2 They use the high ratio of non-fatal self harm to suicide (83:1) in our study to suggest our data on incident self harm are unreliable and that “more realistic ratios of suicidal thoughts, acts, and deaths” are seen in the yellow card data. This is potentially misleading.

    The ratio …

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