Abstract
PurposeTo compare the use of antidepressant (AD) classes and compounds in individuals who committed suicide and in controls from the general population and to assess to what extent adherence and current use of different AD classes can affect the risk of committing suicide.MethodsIndividual data on suicide, diagnoses and AD use in Friuli Venezia Giulia from 2005 to 2014 were obtained from the Regional Social and Health Information System. All suicides that had at least one prescription of AD in the 730 days before death (N = 876) were included as cases. Each case was matched with regard to age and sex with five controls from the general population. The association between suicide and AD use was assessed using conditional logistic regression analysis.ResultsAlmost 70% of all suicides occurring in the10-year period had been prescribed AD. Selective serotonin reuptake inhibitors (SSRIs) accounted for more than the 90% of the prescriptions, with paroxetine the most prescribed AD. All AD compounds and classes were not associated with a higher suicide risk, with the exception of SSRI (OR = 1.6). A decreasing trend in suicide risk was observed when adherent subjects or current AD users were compared to the others.ConclusionsAD treatment is an important factor for preventing suicide, since the use of AD at adequate dosage and for a proper duration was associated with a lower suicide risk. The proper use of AD should be ascertained by physicians, particularly in a primary care context.
Highlights
Suicide is a major public health problem
Suicides treated with antidepressants in the 2 years prior to death were 876
The percentage of suicides treated with antidepressants was 69.5% during the 10-year period
Summary
Suicide is a major public health problem. There is a close link between suicide and psychiatric diseases, foremost depression [1]. In many countries increased use of antidepressants during the last two decades has been accompanied by decreased suicide rates [16, 17]. Such an association has been documented in the Italian region of Friuli Venezia Giulia (FVG) [3]. A British study found that the risk of suicide among patients treated with antidepressants decreased with the length of treatment [13]. Our study found that the risk of suicide in patients with somatic disorders was not higher than the risk of the general population, when patients were adherent to antidepressant medication [19]. There is a need for more studies of the effects of antidepressants on suicide risk, with a focus on qualitative parameters
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