Antidepressant use in suicides: a case-control study from the Friuli Venezia Giulia Region, Italy, 2005-2014.
OBJECTIVE
To compare the use of antidepressant (AD) classes and compounds in individuals who committed suicide and in controls from the general population and to assess to what extent adherence and current use of different AD classes can affect the risk of committing suicide.


METHODS
Individual data on suicide, diagnoses and AD use in Friuli Venezia Giulia from 2005 to 2014 were obtained from the Regional Social and Health Information System. All suicides that had at least one prescription of AD in the 730 days before death (N = 876) were included as cases. Each case was matched with regard to age and sex with five controls from the general population. The association between suicide and AD use was assessed using conditional logistic regression analysis.


RESULTS
Almost 70% of all suicides occurring in the10-year period had been prescribed AD. Selective serotonin reuptake inhibitors (SSRIs) accounted for more than the 90% of the prescriptions, with paroxetine the most prescribed AD. All AD compounds and classes were not associated with a higher suicide risk, with the exception of SSRI (OR = 1.6). A decreasing trend in suicide risk was observed when adherent subjects or current AD users were compared to the others.


CONCLUSIONS
AD treatment is an important factor for preventing suicide, since the use of AD at adequate dosage and for a proper duration was associated with a lower suicide risk. The proper use of AD should be ascertained by physicians, particularly in a primary care context.
Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden. giulio.castelpietra@regione.fvg.it.|Italian Collaborating Centre for the WHO Family of International Classifications, Udine, Italy. giulio.castelpietra@regione.fvg.it.|Primary care services Area, Central Health Directorate, Region Friuli Venezia Giulia, Trieste, Italy. giulio.castelpietra@regione.fvg.it.
Giulio
G
Castelpietra
Epidemiological Service, Central Health Directorate, Friuli Venezia Giulia Region, Udine, Italy.
Michele
M
Gobbato
Epidemiological Service, Central Health Directorate, Friuli Venezia Giulia Region, Udine, Italy.
Francesca
F
Valent
Department of Medical Sciences, University of Trieste, Trieste, Italy.
Clarissa
C
De Vido
Psychiatric Unit, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy.
Matteo
M
Balestrieri
Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden.
Göran
G
Isacsson
D000928:Antidepressive Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy / Q000453:epidemiology; D017374:Paroxetine / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D000092864:Suicide Prevention
D000928:Antidepressive Agents; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors
Adherence; Antidepressants; Case-control; Current use; Suicide