Antidepressants and suicide mortality

Citation
A. Ohberg et al., Antidepressants and suicide mortality, J AFFECT D, 50(2-3), 1998, pp. 225-233
Citations number
51
Categorie Soggetti
Psychiatry,"Neurosciences & Behavoir
Journal title
JOURNAL OF AFFECTIVE DISORDERS
ISSN journal
01650327 → ACNP
Volume
50
Issue
2-3
Year of publication
1998
Pages
225 - 233
Database
ISI
SICI code
0165-0327(199809)50:2-3<225:AASM>2.0.ZU;2-W
Abstract
Background: This paper presents a nationwide analysis of suicide mortality in Finland from 1990 to 1995, when the total use of antidepressants, especi ally that by selective serotonin reuptake inhibitors (SSRIs) expanded in th e country. Methods: Suicide rate was analysed by various methods including that by intake of antidepressants. Various antidepressants were compared by calculating fatal toxicity indices (FTI) by relating number of fatal poiso nings by a drug to its consumption. Results: The expanded use of antidepres sants coincided with an increased number of deaths caused by these drugs. T he proportion of suicides committed by use of antidepressants among all sui cides increased from 5.6% to 8.4%. The total suicide rate, however, decline d significantly. This was mainly accounted for by the reduced suicide rates by hanging and carbomonoxide poisoning, which outnumbered the increased fi gures of suicides by poisoning. On the whole, 82% of suicides by antidepres sants were committed by use of tricyclics. Use Df doxepin and amitriptyline remained steady, and their FTIs were constantly high. The lowest FTIs were associated with fluoxetine, citalopram, mianserin and moclobemide. Limitat ions: The method ignores causality between the increased use of SSRIs and s uicide mortality. Various factors affecting risk of suicide or choice of a method remain outside the scope of the data. Conclusion: The increased use of SSRIs coincided with a significant decline:in suicide mortality. However , suicides by use of antidepressants showed an upward trend. Therefore, in suicide prevention, risks and benefits of antidepressants should be conside red in choosing treatment for depressive patients. (C) 1998 Elsevier Scienc e B.V. All rights reserved.