Antidepressant use and mortality in Finland: a register-linkage study from a nationwide cohort.
BACKGROUND
It is generally acknowledged that depressed patients need specific attention during the first weeks after initiation of antidepressant (AD) treatment because of the increased risk of suicide.


METHODS
The study population consisted of all individuals residing in Finland from 1999 to 2003 who had purchased a prescribed antidepressant at least once but had no preceding antidepressant prescription. Data sources were the National Prescription Register, the Causes of Death Register, Census Data of Statistics Finland, and the National Care Register. Follow-up started at the first purchase and ended at the end of 2003 or death. Data on prescriptions were used to construct contiguous treatment periods of follow-up time. Life-table analysis with Poisson regression was used to estimate risk ratios (RR) of antidepressant use with respect to all-cause mortality and to deaths from suicide.


RESULTS
Current AD use was associated with a lowered all-cause mortality (RR = 0.18, 95% CI = 0.18-0.19) compared with those who filled one previous prescription only. There was no difference in suicide mortality when any current antidepressant usage was compared to the one-prescription group. Current SSRI usage was associated with lower risk of suicide compared to the one-prescription or other antidepressant groups (RR 0.47, 0.38-0.59).


CONCLUSIONS
Current AD treatment is associated with decreased all-cause mortality rates in patients who have ever had AD treatment.
Haukka
Jari
J
National Institute for Health and Welfare, Helsinki, Finland. jari.haukka@thl.fi
Arffman
Martti
M
Partonen
Timo
T
Sihvo
Sinikka
S
Elovainio
Marko
M
Tiihonen
Jari
J
Lönnqvist
Jouko
J
Keskimäki
Ilmo
I
D000293:Adolescent; D000928:Antidepressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002423:Cause of Death; D015331:Cohort Studies; D003625:Data Collection; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D055656:Prescriptions; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors