Antidepressant use in elderly suicide victims in New York city: an analysis of 255 cases.
OBJECTIVE
We examined postmortem evidence of antidepressant, analgesic, and anxiolytic-hypnotic drugs in suicide victims aged 65 years and older.


METHODS
We assessed data on Medical Examiner-certified suicide victims aged 65 years or older from 2001 through 2004 who had resided and died in New York City and who underwent toxicologic investigation for antidepressant, analgesic, and anxiolytic-hypnotic drugs. We calculated annual population-based suicide rates and rates of positive toxicologic findings for each of the 3 classes of medications across 3 age strata: 65 to 74, 75 to 84, and 85 years and older.


RESULTS
There were 255 certified suicide victims among New York City residents aged 65 years or older from 2001 through 2004. Results of toxicologic testing were available for 63.5% (162) of suicide victims. Antidepressants were detected in 22.0% of suicide victims aged 65 to 74 years, 26.8% of those aged 75 to 84 years, and 16.7% of those aged 85 years and older. The oldest age stratum had both the highest suicide rates in the over-65-years population at 10.7 per 100,000 and the lowest percentage of antidepressant use among all geriatric suicide victims.


CONCLUSIONS
Rates of detection of antidepressant medication were low for all geriatric suicide victims, especially the oldest. Analgesics and anxiolytic-hypnotics may have been taken in lieu of antidepressants by suicide victims aged 85 years and older. Assuming that many of the suicide victims had clinically treatable depression, these findings implicate problems in the delivery of specific antidepressant pharmacologic treatment to the "old-old."
Abrams
Robert C
RC
Department of Psychiatry, Weill Cornell Medical College, New York, N.Y. 10021, USA. rabrams@med.cornell.edu
Leon
Andrew C
AC
Tardiff
Kenneth
K
Marzuk
Peter M
PM
Li
Chunshan
C
Galea
Sandro
S
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002423:Cause of Death; D003334:Coroners and Medical Examiners / Q000706:statistics & numerical data; D003625:Data Collection / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000188:drug therapy / Q000401:mortality; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D009519:New York City; D012737:Sex Factors; D013405:Suicide / Q000706:statistics & numerical data*; D014505:Urban Population / Q000706:statistics & numerical data*; D000092864:Suicide Prevention
D000700:Analgesics; D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives