Papers

Use of antidepressants among people committing suicide in Sweden

Department of Clinical Neuroscience and Family Medicine, Section of Psychiatry, Karolinska Institute, Huddinge University Hospital, S-14186 Huddinge, Sweden Department of Toxicology, National Laboratory of Forensic Chemistry, Linkoping, Sweden Centre for Suicide Research and Prevention, Karolinska Hospital, Stockholm, Sweden Danuta Wasserman, head Department of Medical Laboratory Sciences and Technology, Division of Clinical Pharmacology, Karolinska Institute, Huddinge University Hospital, Huddinge, Sweden. Correspondence and reprint requests to: Dr Isacsson.

Abstract

Objective : To analyse the outcome of depression in the Swedish population as reflected by the detection of antidepressants in a national forensic toxicological screening programme of unnatural deaths.
Design : Antidepressants detected by the National Laboratory of Forensic Chemistry were related to data on use expressed in person years of exposure.
Subjects : All 7000 cases of unnatural death with results from forensic toxicological screening in 1990-1; this included 3400 (85%) of the 4000 cases of suicide in Sweden.
Main outcome measures : Number of findings of antidepressants in the screening programme and number of findings of different antidepressants in relation to their use.
Results : Antidepressants were found in 585 screening tests, corresponding to 542 subjects or less than 16% of the 3400 cases of suicide. Newer,less toxic antidepressants were found more often than the older compounds. Toxic concentrations of antidepressants were found in only 190 cases (5.6%).
Conclusion : A consistent finding in surveys of suicide is that about half of the patients who commit suicide are depressed. The current data suggest that most depressed patients who commit suicide are not taking antidepressants immediately before death.Therapeutic failure may be a greater problem with antidepressants than toxicity as the results did not indicate any advantage of the newer, less toxic antidepressants. All causes of death should be included in risk analyses, thereby providing an estimate of effectiveness as well as toxicity of antidepressants.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

Antidepressants and suicide

E Vuori, J Lonnqvist, and T Klaukka
BMJ 1994 308: 1573. [Extract] [Full Text]

Suicide and the use of antidepressants Drug treatment of depression is inadequate

E Isometsa, M Henriksson, M Heikkinen, H Aro, J Lonnqvist, A Owen, T O'Hare, H Goode, K Matthews, G Isacsson, P Holmgren, D Wasserman, and U Bergman
BMJ 1994 308: 915-916. [Extract] [Full Text]

This article has been cited by other articles:

• Isacsson, G., Rich, C. L (2001). Regular review: Management of patients who deliberately harm themselves. BMJ 322: 213-215 [Full text]  
• DONOVAN, S., MADELEY, R., CLAYTON, A., BEEHARRY, M., JONES, S., KIRK, C., WATERS, K., GARDNER, D., FAULDING, J. (2000). Deliberate self-harm and antidepressant drugs: Investigation of a possible link. Br. J. Psychiatry 177: 551-556 [Abstract] [Full text]  
• Healy, D., Langmaak, C., Savage, M. (1999). Suicide in the course of the treatment of depression. J Psychopharmacol 13: 94-99 [Abstract]  
• Bergman, U., Isacsson, G., Wiholm, B.-E., Sundström, A., Alfredsson, L., Chen, Y.-T., Makuch, R. W, Lindberg, G., Ranstam, J., Melander, A., Bingefors, K., Råstam, L. (1998). Use of calcium channel blockers and risk of suicide. BMJ 317: 1076-1076 [Full text]  
• Rivara, F. P., Grossman, D. C., Cummings, P. (1997). Injury Prevention- Second of Two Parts. NEJM 337: 613-618 [Full text]  
• Donoghue, J., Tylee, A., Wildgust, H. (1996). Cross sectional database analysis of antidepressant prescribing in general practice in the United Kingdom, 1993-5. BMJ 313: 861-862 [Full text]  
• Bernadt, M., Hammill, R. (1995). Study's conclusion is unwarranted. BMJ 311: 56-56 [Full text]  
• Gram, L. F, Kragh-Sorensen, P., Isacsson, G., Bergman, U. (1995). Study did not consider treatment efficacy. BMJ 311: 55b-56 [Full text]  
• Jick, S. S, Dean, A. D, Jick, H. (1995). Antidepressants and suicide. BMJ 310: 215-218 [Abstract] [Full text]  
• Isacsson, G., Holmgren, P., Wasserman, D., Bergman, U. (1995). Antidepressants and suicide. BMJ 310: 127a-127 [Full text]  
• Isacsson, G., Redfors, I., Wasserman, D., Bergman, U. (1994). Choice of antidepressants: questionnaire survey of psychiatrists and general practitioners in two areas of Sweden. BMJ 309: 1546-1549 [Abstract] [Full text]  
• Gram, L. F. (1994). Fluoxetine. NEJM 331: 1354-1361 [Full text]  
• Cowen, P, Thompson, C, Roberts, A, Nakielny, J, Eckett, S, Hindmarch, I, Kerr, J S, Ashford, J J, Henry, J A, Hale, A S, Tracey, D, Gonzaga, R, Naik, P, Brandt, A, Bergemann, R, Puri, B K, Thakore, J H, Feemantle, N, Sheldon, T A, Song, F, Mason, J, House, A (1994). Selective serotonin reuptake inhibitors Drugs related to tricyclic antidepressants are a mixed bag. BMJ 309: 1082-1082 [Full text]  
• Vuori, E, Lonnqvist, J, Klaukka, T (1994). Antidepressants and suicide. BMJ 308: 1573-1573 [Full text]  
• Isometsa, E, Henriksson, M, Heikkinen, M, Aro, H, Lonnqvist, J, Owen, A, O'Hare, T, Goode, H, Matthews, K, Isacsson, G, Holmgren, P, Wasserman, D, Bergman, U (1994). Suicide and the use of antidepressants Drug treatment of depression is inadequate. BMJ 308: 915-916 [Full text]