Association between antidepressant prescribing and suicide in Australia, 1991-2000: trend analysis
- PMID: 12742921
- PMCID: PMC154757
- DOI: 10.1136/bmj.326.7397.1008
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.
Conclusions: Changes in suicide rates and exposure to antidepressants in Australia for 1991-2000 are significantly associated. This effect is most apparent in older age groups, in which rates of suicide decreased substantially in association with exposure to antidepressants. The increase in antidepressant prescribing may be a proxy marker for improved overall management of depression. If so, increased prescribing of selective serotonin reuptake inhibitors in general practice may have produced a quantifiable benefit in population mental health.
Figures
Comment in
-
Antidepressant prescribing and suicide: Antidepressants do not reduce suicide rates.BMJ. 2003 Aug 2;327(7409):288-9; author reply 289. doi: 10.1136/bmj.327.7409.288-c. BMJ. 2003. PMID: 12896950 Free PMC article. No abstract available.
-
Antidepressant prescribing and suicide: Analysis is misleading.BMJ. 2003 Aug 2;327(7409):288; author reply 289. doi: 10.1136/bmj.327.7409.288. BMJ. 2003. PMID: 12896951 Free PMC article. No abstract available.
-
Antidepressant prescribing and suicide: Decline in suicide rate among older people predates 1991.BMJ. 2003 Aug 2;327(7409):288; author reply 289. doi: 10.1136/bmj.327.7409.288-b. BMJ. 2003. PMID: 12896952 Free PMC article. No abstract available.
-
Antidepressant prescribing and suicide: Associations attribute possible causality inappropriately.BMJ. 2003 Aug 2;327(7409):288; author reply 289. doi: 10.1136/bmj.327.7409.288-a. BMJ. 2003. PMID: 12896953 Free PMC article. No abstract available.
References
-
- McManus P, Mant A, Mitchell P, Montgomery WS, Marley J, Auland ME. Recent trends in the use of antidepressant drugs in Australia, 1990-1998. Med J Aust. 2000;173:458–461. - PubMed
-
- Carlsten A, Waern M, Ekedahl A, Ranstram J. Antidepressant medication and suicide in Sweden. Pharmacoepidemiol Drug Saf. 2001;10:525–530. - PubMed
-
- Isacsson G. Suicide prevention—a medical breakthrough? Acta Psychiatr Scand. 2000;102:113–117. - PubMed
-
- Rihmer Z. Can better recognition and treatment of depression reduce suicide rates? A brief review. Eur Psychiatry. 2001;16:406–409. - PubMed
-
- Barbui C, Campomori A, D'Avanzo B, Negri E, Garattini S. Antidepressant drug use in Italy since the introduction of SSRIs: national trends, regional differences and impact on suicide rates. Soc Psychiatry Psychiatr Epidemiol. 1999;34:152–156. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical