Association between mortality from suicide in England and antidepressant prescribing: an ecological study

Morgan, Oliver W. C.; Griffiths, Clare; Majeed, Azeem
January 2004
BMC Public Health;2004, Vol. 4, p63
Academic Journal
Background: Antidepressant prescribing has been increasing in England. Studies in other countries suggest that while this may be associated with reduced suicide rates, it may also be associated with increased fatal poisoning from antidepressant drugs. We therefore conducted an ecological study to assess the association between prescription rates for antidepressants and suicide or fatal antidepressant-related poisoning in England. Methods: The Office for National Statistics provided information on the number of suicides, antidepressant-related poisoning deaths and populations for England between 1993 and 2002. The Department of Health supplied data on prescriptions for all antidepressants dispensed in England. Associations between prescriptions and deaths were assessed using Spearman's rank correlation coefficient. Results: There were 46,747 suicides, 3,987 deaths involving tricyclic antidepressants and 430 involving selective serotonin re-uptake inhibitors and other antidepressants. Increased antidepressant prescribing was statistically associated with a fall in suicide rates (Spearman's rs = - 0.73, p = 0.02) and fatal poisoning involving tricyclic antidepressants (rs = -0.64, p = 0.05). In contrast, increased prescribing of selective serotonin re-uptake inhibitors and other antidepressants was statistically associated with an increase in fatal poisoning involving these drugs (rs = 0.99, p < 0.001). Conclusion: Increased prescribing of antidepressants may indicate improved diagnosis and treatment of depression in primary care. Our analysis suggests that this was accompanied by lower suicide rates. A decrease in poisoning deaths involving tricyclic antidepressants may suggest a change in preference for using serotonin reuptake inhibitors and other antidepressant drugs for high-risk patients. This may also partially explain the increase in deaths involving these drugs. Due to the ecological nature of the design, we cannot say conclusively whether reduced suicide rates are a direct consequence of increased antidepressant prescribing rates. To confirm these associations, individual level data on prescribing and suicide is needed.


Related Articles

  • Patterns of Antidepressant Use in Italy: Therapy Duration, Adherence and Switching. Degli Esposti, Luca; Piccinni, Carlo; Sangiorgi, Diego; Fagiolini, Andrea; Buda, Stefano // Clinical Drug Investigation;Nov2015, Vol. 35 Issue 11, p735 

    Aim: This study aimed to describe the prescription pattern of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) in an Italian setting, focusing on therapy duration, switching and adherence. Method: Historic cohort study, based on...

  • Treatment of Neuropsychiatrie Symptoms in Dementia. Friedman, Michael // Medicine & Health Rhode Island;Jul2012, Vol. 95 Issue 7, p212 

    The article discusses on neuropsychiatric (NP) symptoms associated with dementia and its treatment. It states that most patients diagnosed with dementia develop neurospsychiatric symptoms at some stage during their illness. It is associated with an accelerated decline in overall patient...

  • "They Took My Depression and Then Medicated Me into Madness": Co-Constructed Narratives of SSRI-Induced Suicidality. Liebert, Rachel; Gavey, Nicola // Radical Psychology: A Journal of Psychology, Politics & Radicali;2006, Vol. 5, p4 

    Evidence that selective serotonin reuptake inhibitor (SSRI) 'antidepressant' use may elicit suicidal thoughts and behaviours in people of all ages has been circulating for nearly thirty years. Nonetheless, knowledge of the possibility and/or significance of these adverse effects appears to...

  • Why Did Julie Take Her Life? Schindehette, Susan; Calandra, Bob; Podesta, Jane Sims; Williams, Kelly // People;4/5/2004, Vol. 61 Issue 13, p58 

    This article discusses how anti-depressants relate to the suicide of Julie Woodward. From the very beginning, Tom and Kathy Woodward's firstborn was a golden child. And by the time Julie Woodward reached her sophomore year at a Catholic high school near her home in North Wales, Pa. Julie...

  • Suicidality with Fluoxetine. Beasley Jr, C.M. // CNS Drugs;1998, Vol. 9 Issue 6, p513 

    Comments on psychiatrist Alyson J. Bond's article on relationship between selective serotonin reuptake inhibitor (SSRI) antidepressants and suiciadility. Lack of confounding factors in relating fluoxetine and suiciadility; Unreliability of clinical case material used to evaluate the link...

  • Antidepressants Medications and the Relative Risk of Suicide Attempt. Mandour, R. A. // Toxicology International;Jan2012, Vol. 19 Issue 1, p42 

    This study was conducted on patients (n=1283) of different ages, 924 males and 359 female. These patients were attended to poison unit at emergency hospital, Mansoura University during the period from January 2002 to December 2009. The aim of this study was to characterize patients on...

  • Depression in Children and Adolescents.  // American Family Physician;11/15/2000, Vol. 62 Issue 10, p2297 

    Depression among children and adolescents is common but frequently unrecognized. It affects 2 percent of prepubertal children and 5 to 8 percent of adolescents. The clinical spectrum of the disease can range from simple sadness to a major depressive or bipolar disorder. Risk factors include a...

  • Depression: Making the diagnosis and using SSRIs in the older patient. Reynolds III, Charles F. // Geriatrics;Oct96, Vol. 51 Issue 10, p28 

    Describes how to diagnose depression and use selective serotonin reuptake inhibitors (SSRI) in the older patients. Scope and consequences of depression; Clinical and social barriers in the recognition and treatment of depression; Risk factors; Distinction from depressed move and dementia or...

  • Antidepressants: SSRIs may be safe for pediatric depression.  // PharmaWatch: CNS;March 2004, Vol. 3 Issue 3, p7 

    Assesses the safety of selective serotonin reuptake inhibitors (SSRI) for pediatric depression. Failure of SSRI to increase the risk of suicide in children and teenagers; Approval on the use SSRI for children; Usage of pediatric antidepressants.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics