Lower suicide rates in older people only partially due to antidepressants


Lower suicide rates in older people only partially due to antidepressants

Antidepressant use has likely accounted for only ten percent of the recent fall in suicide rates among middle aged and older people, according to a large study published in May 2008 in the Journal of Epidemiology and Community Health.

On a global scale, over 800,000 people commit suicide yearly, but this rate has been falling in many countries. Many attribute this result to  better recognition of depression and the more prevalent administration of antidepressants. In particular, the relatively new selective serotonin reuptake inhibitors (SSRIs), which attempt to balance seratonin levels by preventing excessive reuptake into neurons, are noted.

Since 1990, the sales of antidepressants in Denmark have risen from 8.4 per 1000 to 52.2 per 1000 in 2000. In the meantime, suicide rates among older people have dropped considerably, from 52.2 in 1980 to 22.1 per 100,000 of the population in 1000. Earlier research in Scandinavia and the United States has indicated that an increase in the use of antidepressants by fivefold could lead to a 25% decrease in suicide rates, with SSRIs saving upwards of 33,000 lives.

However, according a study conducted between 1996 and 2000 on more than two million Danes aged 50 and above, the credit given to antidepressants might not be appropriately attributed. In this study, the changes in the numbers of middle aged and older people committing suicide were examined, along with the types of antidepressant drugs they had been prescribed. In fact, only one in five of the patients who were committing suidice was taking antidepressants at the time of death.

For example, in older men, suicide rates in the population fell by almost 10 per 100,000 during this time frame. When isolated to the recipients of antidepressants, the fall was less than 1 per 100,000. In the case of older women, of the 3.3 in 100,000 drop the population experienced, only 0.4 of 100,000 were being treated with antidepressants.

There was no clear trend between the type of treatment administered and suicide rates, although men taking SSRIs were slightly more suicidal than those taking tricyclics. However, the group taking antidepressants had a suicide rate five to six times that of the group who was not.

Current antidepressant treatments, therefore, only account for a part of the drops in suicide rates among older people, according to the authors. Nevertheless, they say, diagnosis and treatment of depression among older people is still an important goal.

Increased use of antidepressants and decreasing suicide rates: a population-based study using Danish register data

A Erlangsen, V Canudas-Romo, Y Conwell

J Epidemiol Community Health 2008; 62: 448-454.

doi:10.1136/jech.2007.061580

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Elderly - Depression and Suicide in Old Age Senior Health Center Everyday Health (Video Medical And Professional 2020).

Section Issues On Medicine: Psychiatry