EPIDEMIOLOGIC DATA SUGGEST ANTIDEPRESSANTS REDUCE SUICIDE RISK AMONG DEPRESSIVES

In spite of the availability of antidepressant medication for several decades, it has not been shown that such medication lowers the risk fo r suicide in depressed patients. This report explores this apparent pa radox by means of pharmacoepidemiological methods. Data on the prevale nce of depression in the population and among suicides as well as data on the prevalence of antidepressant medication in depressed suicides were obtained from a review of the literature. Data on the prevalence of antidepressant medication in the population in 1990-1991 were obtai ned from the statistics of the Swedish National Corporation of Pharmac ies. It was found that only one in five depressed individuals with maj or depression were treated with antidepressants in Sweden. The calcula ted risk for suicide among depressed patients who were treated with an tidepressants was 141 per 100 000 person years and, among the untreate d, 259 per 100 000 person years (i.e., 1.8 times higher among the untr eated). This supports the hypothesis that antidepressant medication de creases the risk for suicide in depressed patients. The reason this ha s not been obvious in the general suicide statistics seems to be that so few depressed people are treated with antidepressants. Effective su icide prevention strategies should include intensive efforts to recogn ize and treat more depressed people.