Citation

Castelpietra G, Bortolussi L, Gobbato M, Arnoldo L, Balestrieri M, Wettermark B. Basic Clin. Pharmacol. Toxicol. 2019; 124(3): 312-320.

Affiliation

Centre for Pharmacoepidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.

Copyright

(Copyright © 2019, Nordic Pharmacological Society, Publisher John Wiley and Sons)

DOI

10.1111/bcpt.13140

PMID

30281896

Abstract

Although continued use of antidepressants (AD) has been found to be associated with a lower risk of suicide, AD discontinuation is reported repeatedly. The aim of this case-control study, thus, was to assess whether discontinuation to AD was associated with an increased risk of suicide, according to different genders and age groups. The Social and Health Information System of Friuli Venezia Giulia Region, Italy, was used to collect data on suicides, diagnoses and AD use from 2005 to 2014. We selected, as cases, all suicides that had at least one prescription of AD in the 730 days before death (N=876), and we matched with regard to age and sex each case with 5 controls from the general population. Conditional logistic regression analyses were used to assess the association between suicide and modifications of AD treatment. We found that 70% of suicides and controls from the general population discontinued AD in the two years before the index date. In two thirds of them, discontinuations were two or more. Discontinuation of AD, however, did not represent a significant risk factor for suicide. More appropriate care of depression, particularly by primary care physicians who widely prescribe AD, should be fostered in order to prevent suicide. However, more research is needed to assess to which extent AD discontinuation can affect suicidal risk. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en

Keywords

Antidepressants; Case-control; Discontinuation; Drug utilization; Suicide