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Antidepressants and suicide mortality
1Department of Forensic Medicine, University of Helsinki, Finland. annakatri.ohberg@helsinki.fi
Journal of Affective Disorders
|December 19, 1998
Summary
Antidepressant use rose in Finland alongside increased suicide deaths from these drugs, yet overall suicide rates fell. Careful consideration of antidepressant risks and benefits is crucial for patient treatment and suicide prevention.
Area of Science:
- Public Health
- Epidemiology
- Psychiatry
Background:
- Nationwide analysis of suicide mortality in Finland (1990-1995).
- Examined trends during a period of expanding antidepressant use, particularly selective serotonin reuptake inhibitors (SSRIs).
Purpose of the Study:
- Analyze suicide rates in relation to antidepressant intake.
- Compare the toxicity of various antidepressants using fatal toxicity indices (FTI).
Main Methods:
- Suicide rates analyzed by various methods, including antidepressant intake.
- Fatal Toxicity Index (FTI) calculated by correlating drug-related fatalities with consumption data.
Main Results:
- Increased antidepressant use correlated with more deaths from these drugs (5.6% to 8.4% of all suicides).
- Overall suicide rates significantly declined, primarily due to reduced deaths from hanging and CO poisoning.
- Tricyclic antidepressants accounted for 82% of antidepressant-related suicides, with high FTIs for doxepin and amitriptyline.
- SSRIs like fluoxetine and citalopram showed the lowest FTIs.
Conclusions:
- Increased SSRI use coincided with a significant decrease in overall suicide mortality.
- Suicides involving antidepressants showed an upward trend, necessitating a balance of risks and benefits in treatment decisions.
- Causality between SSRI use and suicide mortality, along with other influencing factors, was not assessed.