Table 4 Associations between selected antidepressant exposures and ED or hospital encounter within 30 days, stratified by fluoxetine-equivalent dose^a.

Exposure	N	Encounters		Unadjusted			Adjusted^b
Exposure	N	n	%	Odds ratio	95% CI	P	Odds ratio	95% CI	p
Any Antidepressant
No antidepressant	20,457	1896	9.3	Ref	Ref	Ref	Ref	Ref	Ref
<20 mg Fluoxetine-equivalent	1140	261	22.9	2.91	2.51–3.36	<0.001	0.94	0.80–1.11	0.48
≥20 mg Fluoxetine-equivalent	3437	710	20.7	2.55	2.32–2.80	<0.001	0.87	0.77–0.99	0.04
≥40 mg Fluoxetine-equivalent	1684	345	20.5	2.52	2.22–2.87	<0.001	0.79	0.67–0.94	0.006
Any SSRI
No antidepressant	20,457	1896	9.3	Ref	Ref	Ref	Ref	Ref	Ref
<20 mg Fluoxetine-equivalent	321	62	19.3	2.34	1.77–3.10	<0.001	0.81	0.60–1.10	0.18
≥20 mg Fluoxetine-equivalent	2423	497	20.5	2.53	2.26–2.82	<0.001	0.88	0.77–1.02	0.09
≥40 mg Fluoxetine-equivalent	1049	210	20	2.45	2.09–2.87	<0.001	0.81	0.67–0.98	0.03
Bupropion^c
No antidepressant	20,457	1896	9.3	Ref	Ref	Ref	Ref	Ref	Ref
<20 mg Fluoxetine-equivalent	362	64	17.7	2.10	1.60–2.77	<0.001	0.71	0.52–0.95	0.02
≥20 mg Fluoxetine-equivalent	227	39	17.2	2.03	1.43–2.88	<0.001	0.68	0.47–0.99	0.04
Antidepressants with FIASMA Activity^d
No Antidepressant	20,457	1896	9.3	Ref	Ref	Ref	Ref	Ref	Ref
<20 mg Fluoxetine-equivalent	718	157	21.9	2.74	2.28–3.29	<0.001	0.89	0.73–1.09	0.25
≥20 mg Fluoxetine-equivalent	2696	550	20.4	2.51	2.26–2.79	<0.001	0.88	0.77–1.01	0.07
≥40 mg Fluoxetine-equivalent	1178	229	19.4	2.36	2.03–2.75	<0.001	0.78	0.65–0.94	0.009

CI confidence interval, FIASMA functional inhibition of acid sphingomyelinase, SSRI selective serotonin reuptake inhibitor,
^aAnalyses stratified by fluoxetine-equivalent dose were performed for classes of antidepressants and individual drugs (if not already included in one of the classes) that were significantly associated with reduced ED or hospital encounters (adjusted p value < 0.05 in Table 3).
^bModels were adjusted for sex, age, race and ethnicity, obesity, number of diagnoses, history of mood or anxiety disorder, history of other psychiatric disorders, number of home medications, concurrent exposure to benzodiazepine or Z drug, concurrent exposure to antipsychotic drugs, and concurrent exposure to non-antidepressant drugs with FIASMA or S1R activity (listed in Table S1).
^cBupropion not tested at ≥40 mg fluoxetine-equivalent due to small number of cases (N = 5).
^dAntidepressants with FIASMA activity included amitriptyline, citalopram, clomipramine, desiparmine, doxepin, escitalopram, fluoxetine, fluvoxamine, imipramine, nortriptyline, paroxetine, sertraline, and venlafaxine.

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