Association between antidepressant prescribing and suicide in Australia, 1991-2000: trend analysis

Abstract

Objective To examine the association between trends in antidepressant prescribing and suicide rates in Australia for 1991-2000. Design Analysis of databases of suicide and rates of antidepressant prescribing according to age and sex. Setting Australian Bureau of Statistics data, sales data from the Australian pharmaceutical industry, prescribing data in general practice. Subjects Men and women aged 15 years and over in 10 year age groups. Main outcome measures Trends in suicide rates and trends in antidepressant prescribing. Association measured by Spearman's rank correlations. Results While overall national rates of suicide did not fall significantly, incidence decreased in older men and women and increased in younger adults. In both men (r s = − 0.91; P < 0.01) and women (r s = − 0.76; P < 0.05) the higher the exposure to antidepressants the larger the decline in rate of suicide.

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“…As such, more patients with these conditions can now be safely and successfully treated than before, and there is evidence that suicide rates in many countries are beginning to drop because of pharmacotherapy for depression and anxiety disorders. [7][8][9] (However, we should note that a recent study by Kessler et al 10 found no significant decrease in suicidal thoughts, plans, gestures, or attempts in the U.S. during the 1990s. )…”

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“…Simultaneously the rate of suicide for this age span has increased in Australia. For men aged 25-34 the use of antidepressants has increased more than six times during the period and the suicide rate has increased by almost 17% (10). Among the suicidal intoxications in Sweeden, selective serotonin reuptake inhibitors (SSRI) and TCA were detected in 12% and 10% respectively.…”

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“…This finding indicates that this population is living longer. However, a study on the metabolic disorders of patients with schizophrenia showed that their life expectancy is 20% shorter than that of individuals without schizophrenia (29)(30) .…”

“…Because treatment cannot be discontinued, doctors usually write prescriptions with a large number of doses and patients accumulate large amounts of potentially risky substances in their homes (27)(28) . In this regard, one should keep in mind that depressive patients are more prone to suicide attempts when they have easy access to psychoactive drugs (29) .…”