Antidepressants May Lower Suicide Risk
Better Treatment of Depression Aids in Suicide Prevention
May 8, 2003 -- The surge in antidepressant use over the last
decade may have played an important role in suicide prevention. A new
Australian study shows increases in antidepressant prescribing were closely
correlated with a decline in suicide rates, especially among the elderly.
Experts say links between antidepressant prescribing and
suicide trends on a nationwide level don't necessarily mean that antidepressant
use reduces the risk of suicide on an individual basis. But they say the
findings provide further evidence that effective treatment of depression is a
vital tool in suicide prevention.
The study, published in the May 10 issue of the British
Medical Journal, looked at the association between trends in antidepressant
prescribing and suicide rates in Australia from 1991 to 2000.
Researchers found the overall suicide rate for Australian men
and women over age 15 did not change, but they did find significant differences
between age groups in terms of suicide risk and antidepressant prescribing
"We found a steep increase in antidepressant prescribing in
Australia from 1991 to 2000, which unlike in earlier studies, was not
accompanied by a decline in overall rates of suicide because there was a large
increase in suicide in young people over the same time period," write
researcher Wayne D. Hall, director of the Office of Public Policy and Ethics at
the University of Queensland in Brisbane, Australia, and colleagues.
"There was, however, a strong association between the
groups with high exposure to antidepressants and the groups in which the rate
of suicide fell," they write. "The groups with the highest
antidepressant exposure showed the largest declines in suicide."
While the study does not show a cause and effect relationship
between antidepressant use and suicide risk, researchers say there are good
reasons to believe that increased antidepressant prescribing can contribute to
First, depression is a major risk factor for suicide, and use
of antidepressants reduces suicidal tendencies among people with depression.
Second, a prescription for antidepressants is often accompanied by other
medical interventions and counseling that may reduce suicidal behavior.
Finally, researchers say the introduction of selective
serotonin reuptake inhibitors (SSRIs) that are less likely to cause dangerous
drug interactions or side effects than older types of antidepressants has made
primary care doctors more likely to prescribe antidepressants to their patients
without referring them to a specialist. That means patients have greater access
to medications to treat depression and other mental disorders that are risk
factors for suicide.
Treating Depression is Only One Part of Suicide Prevention
"Depression is the number one risk factor for suicide. Of
those that commit suicide, 40% to 70% have a diagnosis of depression," says
Douglas Jacobs, MD, professor psychiatry at Harvard Medical School and founder
of National Depression Screening Day. "However, the majority of people with
depression do not commit suicide."