SUICIDE AND ANTIDEPRESSANTS - IS THERE A CONNECTION

Forensic toxicological screening of 3400 suicides in Sweden in 1990-91 showed that 84% had not taken antidepressants in the period immediate ly prior to death, while 10% had detectable and 6% toxic levels of ant idepressants at the time of death. The findings suggest that underpres cribing and therapeutic failure are the main problems with antidepress ant medication with regard to suicide, while toxicity is of less impor tance. With a 5% prevalence of depression in the population and an ant idepressant usage corresponding to the treatment of about 1%, the use has to increase considerably if more suicides in Sweden are to be prev ented. Furthermore, the quality of antidepressant prescribing (dosage level and ranges) needs to be improved, which can be done with the aid of therapeutic drug monitoring.