Antidepressant drug consumption and public health indicators in Italy, 1955 to 2000.
OBJECTIVE
This study investigated the impact of the increasing consumption of selective serotonin reuptake inhibitors (SSRIs) and newer anti-depressants on the following public health indicators: (1) suicide rates, (2) proportion of completed suicides by poisoning with solid or liquid substances, and (3) hospital admissions for depression and proportion of admissions for depression that were first admissions.


METHODS
Data collected by IMS Health on antidepressants dispensed in Italy from 1983 to 2000 were obtained from the Italian Ministry of Health, while data on suicide deaths from 1955 to 2000 were obtained from the Italian National Institute of Statistics.


RESULTS
In Italy from 1983 to 2000, the use of tricyclic antidepressants remained substantially stable, and the use of SSRIs and newer agents dramatically increased. In contrast, suicide rates for males decreased from 1955 to 1974 and subsequently increased, reaching a peak in 1985 and then declining. In females, suicide rates remained substantially stable until 1978. A subsequent increase occurred up to 1985, followed by a steady decline. Suicide by poisoning using solids or liquids dropped by nearly 50% from 1986 to 2000. Admissions to the hospital for depression showed an erratic pattern; however, no decline was observed. No change was observed in the rate of first admissions for depression.


CONCLUSIONS
Despite a reduction in suicides by poisoning using solids or liquids, the analysis of long-term trends in suicide did not suggest that increases in antidepressant prescribing lie behind recent reductions in population suicides. Furthermore, in Italy, newer antidepressants had no impact on the total number of admissions for depression or on the proportion of all admissions that were first admissions.
Guaiana
Giuseppe
G
Department of Psychiatry, University of Hull, UK.
Andretta
Margherita
M
Corbari
Letizia
L
Mirandola
Mersia
M
Sorio
Adriano
A
D'Avanzo
Barbara
B
Barbui
Corrado
C
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002423:Cause of Death / Q000639:trends; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D004345:Drug Industry / Q000706:statistics & numerical data; D004363:Drug Utilization; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009026:Mortality / Q000639:trends; D010343:Patient Admission / Q000706:statistics & numerical data; D011041:Poisoning / Q000453:epidemiology / Q000401:mortality; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data* / Q000639:trends
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors