Antidepressants and suicide mortality
Antidepressants and suicide mortality
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DOI：
10.1016/s0165-0327(98)00114-1
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发表时间：
1998-09-01
影响因子：
6.6
通讯作者：
Lonnqvist, J
中科院分区：
文献类型：
--
作者：
Ohberg, A;Vuori, E;Lonnqvist, J
工作背景：本文介绍了一个全国范围内的自杀死亡率分析在芬兰从1990年至1995年，当总使用抗抑郁药，特别是选择性5-羟色胺再摄取抑制剂（SSRIs）在该国扩大。方法：采用多种方法分析自杀率，包括服用抗抑郁药。通过计算致命毒性指数（FTI），比较了各种抗抑郁药的致命毒性指数（FTI）。结果：抗抑郁药的广泛使用与这些药物引起的死亡人数增加相吻合。使用抗抑郁药自杀的比例从5.6%上升到8.4%。然而，总的自杀率显著下降。这主要是由于上吊和一氧化碳中毒自杀率的下降，超过了中毒自杀率的上升。总的来说，82%的抗抑郁药自杀者是通过使用三环类药物自杀的。多塞平和阿米替林的使用保持稳定，其FTI持续升高。最低的FTI与氟西汀、西酞普兰、米安色林和吗氯贝胺相关。局限性：该方法忽略了SSRIs使用增加与自杀死亡率之间的因果关系。影响自杀风险或方法选择的各种因素仍然不在数据范围内。结论：SSRIs使用的增加与自杀死亡率的显著下降相一致。然而，使用抗抑郁药自杀的人数呈上升趋势。因此，在自杀预防中，抗抑郁药的风险和效益应考虑在选择治疗抑郁症患者。(C)1998 Elsevier Science B. V.保留所有权利。
Background: This paper presents a nationwide analysis of suicide mortality in Finland from 1990 to 1995, when the total use of antidepressants, especially that by selective serotonin reuptake inhibitors (SSRIs) expanded in the country. Methods: Suicide rate was analysed by various methods including that by intake of antidepressants. Various antidepressants were compared by calculating fatal toxicity indices (FTI) by relating number of fatal poisonings by a drug to its consumption. Results: The expanded use of antidepressants coincided with an increased number of deaths caused by these drugs. The proportion of suicides committed by use of antidepressants among all suicides increased from 5.6% to 8.4%. The total suicide rate, however, declined significantly. This was mainly accounted for by the reduced suicide rates by hanging and carbomonoxide poisoning, which outnumbered the increased figures of suicides by poisoning. On the whole, 82% of suicides by antidepressants were committed by use of tricyclics. Use Df doxepin and amitriptyline remained steady, and their FTIs were constantly high. The lowest FTIs were associated with fluoxetine, citalopram, mianserin and moclobemide. Limitations: The method ignores causality between the increased use of SSRIs and suicide mortality. Various factors affecting risk of suicide or choice of a method remain outside the scope of the data. Conclusion: The increased use of SSRIs coincided with a significant decline:in suicide mortality. However, suicides by use of antidepressants showed an upward trend. Therefore, in suicide prevention, risks and benefits of antidepressants should be considered in choosing treatment for depressive patients. (C) 1998 Elsevier Science B.V. All rights reserved.