Antidepressant prescribing and changes in antidepressant poisoning mortality and suicide in England, 1993-2004.
BACKGROUND
In England, the impact of increased use of antidepressant medications is unclear. We examine associations between antidepressant use, suicide and antidepressant poisoning mortality, adjusted for important covariates.


METHODS
Data on suicide and antidepressant poisoning mortality were provided by the Office for National Statistics. Prescription data were provided by the Department of Health. Age- and sex-specific prescribing rates were estimated from The Health Improvement Network primary care data. We measured the association between prescribing, suicide and poisoning mortality after adjusting for age, sex, calendar year, prescribing rates and use of newer antidepressants drugs.


RESULTS
The prevalence of antidepressant treatment increased during the 1990s for all age and sex groups. Treatment prevalence remained constant from 2002 but declined among children and adolescents. Between 1993 and 2004, age-standardized rates for suicide decreased from 98.2 to 81.3 per million populations and for antidepressants from 9.2 to 7.4 per million populations. Before adjustment, increased antidepressant prescribing was associated with a decrease in suicide (r(s) = -0.90, P < 0.001) and antidepressant poisoning mortality rates (r(s) = -0.65, P = 0.023). This association disappeared after adjustment.


CONCLUSIONS
In England, at a population level, there does not appear to be an association between antidepressant prescribing and antidepressant poisoning mortality or suicide.
Morgan
Oliver
O
Department of Primary Care and Social Medicine, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK. omorgan@bigfoot.com
Griffiths
Clare
C
Majeed
Azeem
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects / Q000506:poisoning*; D019992:Databases as Topic; D003863:Depression / Q000453:epidemiology / Q000401:mortality; D011307:Drug Prescriptions; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D020399:Practice Management; D015995:Prevalence; D012307:Risk Factors; D013405:Suicide / Q000706:statistics & numerical data*
D000928:Antidepressive Agents