Most older suicide victims not on antidepressants

NEW YORK (Reuters Health) - Just one in five adults, 55 years and older, who commit suicide are using antidepressants at the time of their death, according to a report in the Journal of Epidemiology and Community Health.

The findings also indicate that antidepressant use accounted for only 10 percent of the drop in suicide rates seen in this study of Danish individuals between 1996 and 2000.

The results suggest that other factors are largely responsible for the decline in suicide rates, Dr. A. Erlangsen, from the University of Aarhus in Denmark, and colleagues state.

During the 5-year study, which involved over 2 million people, suicide rates in older men fell by 9.7 suicides per 100,000 people. Antidepressant users contributed to this drop by 0.9 suicides.

In women, rates decreased by 3.3 suicides per 100,000 people with antidepressant users accounted for only 0.4 of the decline in suicides.

The average suicide rates for male and female users of tricyclic antidepressants, such as Elavil and Asendin, were 153.3 and 68.8 suicides per 100,000 people, respectively. The corresponding rates for users of selective serotonin reuptake inhibitors, such as Prozac and Zoloft, were 169.0 and 68.6 suicides per 100,000 people.

Overall, 17 percent of men and 28 percent of women had filled an antidepressant prescription within the last month of their life. The fact that just one in five suicide victims were using antidepressants at the time of death suggests that depression and other mood disorders in older adults are often missed, the investigators note.

The results suggest that the success of suicide prevention strategies is likely to be limited if the strategies rely solely on increasing the use of antidepressant medications, the authors conclude. They say that further studies are needed to identify other factors that were responsible for the drop in suicide rates seen in Denmark and elsewhere.

SOURCE: Journal of Epidemiology and Community Health, May 2008.