Suicides by drug poisoning among the elderly in Sweden 1969-1996

Background: Previous studies have shown an association between the rates of suicide employing certain types of medications and the availability of tho se drugs. During recent years, prescription patterns of psychoactive drugs commonly used in suicides have undergone some major changes. This study exa mines whether altered prescription patterns are associated with changes in the rates of drug-related suicides in the elderly. Methods: An ecological s tudy was performed, in which rates of suicide by drug poisoning were relate d to prescription sales of different psychotropic drugs, derived from the N ational Prescription Survey (1987-1996). Results: Benzodiazepines were the dominant drug type used by elderly persons who committed suicide by drug po isoning. Rates of suicide using benzodiazepines increased despite decreasin g prescription sales. Decreasing tricyclic antidepressant sales and increas ing SSRI (selective serotonin reuptake inhibitors) sales were paralleled by decreasing rates of suicides employing antidepressants. The fatality ratio (FR) decreased for the antidepressant group, increased for benzodiazepines and remained more or less unchanged for analgesics among the elderly durin g the study period. Conclusions: Rates of suicide using benzodiazepines inc reased in the elderly despite decreasing prescription sales. Benzodiazepine s should be prescribed restrictively to this age group.