Psychotropics and suicide prevention - Implications from toxicological screening of 5281 suicides in Sweden 1992-1994

Background. Systematic clinical investigations of consecutive suicides have found psychiatric disorders in 90-95% of subjects (depressive disorder 30- 87%). Aims To investigate use of psychotropics in men and women of different ages who commit suicide. Method Results of toxicological screening in 5281 suicides in Sweden 1992-9 4 were studied. Results Psychotropics were detected in 45.3% of the suicides. Antidepressan ts were detected in 12.4% of the men and 26.2% of the women (7.2% and 14.2% , respectively of those under 30 years of age). Neuroleptics or antiepilept ics (in the absence of antidepressants) were detected in 8.3%, and anxiolyt ics/hypnotics alone in 20.5% of the subjects. Overdose by an antidepressant was the probable cause of death in 2.1% of the men and 79% of the women. Conclusions The pattern of psychotropics detected in toxicology was incongr uent with the pattern of diagnoses found in the clinical investigations of suicides mentioned above. Depression appears to be undertreated in individu als committing suicide, especially in men and in subjects under 30 years of age. Declaration of interest Financial support provided by the Karolinska Instit ute, the Swedish Society of Medicine, the Soderstrom-Konig Foundation and t he Bror Gadelius Memorial Foundation.