Use of antidepressants among people committing suicide in Sweden.
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.


METHODS
Antidepressants detected by the National Laboratory of Forensic Chemistry were related to data on use expressed in person years of exposure.


METHODS
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.


METHODS
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%).


CONCLUSIONS
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.
Isacsson
G
G
Department of Clinical Neuroscience and Family Medicine, Karolinska Institute, Huddinge University Hospital, Sweden.
Holmgren
P
P
Wasserman
D
D
Bergman
U
U
D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000032:analysis; D002423:Cause of Death; D003866:Depressive Disorder / Q000453:epidemiology*; D062787:Drug Overdose; D005260:Female; D005554:Forensic Medicine; D006801:Humans; D008297:Male; D012307:Risk Factors; D013405:Suicide; D013548:Sweden / Q000453:epidemiology
D000928:Antidepressive Agents