Decrease in suicide among the individuals treated with antidepressants: a controlled study of antidepressants in suicide, Sweden 1995-2005.
OBJECTIVE
Ecological studies have demonstrated a substantial decrease in suicide in parallel with an increase in the use of antidepressants. Causality cannot, however, be inferred from such studies. The aim of this study was to test on the individual level the hypothesis that treatment with antidepressant medication has been a substantially contributing cause of the decrease in suicide.


METHODS
Time trends in the detection of antidepressants and five 'control medications' in the forensic toxicological screening of 16 937 suicides and 33 426 controls in Sweden 1995-2005.


RESULTS
The expected number of antidepressant-positive suicides in 2005 was 409 if the hypothesis was true and 603 if it was false. The observed number in 2005 was 420. The control medications were detected to the extent that was expected if not preventing suicide.


CONCLUSIONS
The observed trend in the number of suicides with antidepressants was well predicted by the hypothesis that the increased use of antidepressants has been a substantially contributing cause of the decrease in suicide.
Isacsson
G
G
Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Stockholm. Goran.Isacsson@ki.se
Holmgren
A
A
Osby
U
U
Ahlner
J
J
D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D053961:Azabicyclo Compounds / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D002423:Cause of Death / Q000639:trends; D003866:Depressive Disorder / Q000188:drug therapy* / Q000401:mortality*; D011431:Dextropropoxyphene / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D017723:Drug Utilization Review; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use; D012306:Risk; D013405:Suicide / Q000639:trends; D013548:Sweden; D014147:Tramadol / Q000009:adverse effects / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000009:adverse effects / Q000627:therapeutic use; D014700:Verapamil / Q000009:adverse effects / Q000627:therapeutic use; D000077334:Zolpidem; D000092864:Suicide Prevention
D000701:Analgesics, Opioid; D000928:Antidepressive Agents; D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; D011725:Pyridines; D014665:Vasodilator Agents; C515050:zopiclone; D014147:Tramadol; D000077334:Zolpidem; D014700:Verapamil; D011431:Dextropropoxyphene