Psychotropic prescriptions and elderly suicide rates.

Suicide rates in the elderly have declined in recent years in several countries including England and Wales. There have also been major changes in prescribing patterns of psychotropics in many countries during recent years. This study examined the association between a trend of decline in suicide rates in the elderly in England and Wales and changes in the prescribing of psychotropics for the period 1985 to 1996. Data on suicide rates was ascertained from the annual mortality statistics for the years 1985 to 1996. Data on the prescriptions of psychotropics was ascertained from the Statistic Division (SD1E) at the Department of Health. Spearman's rank correlation coefficient (rho) was used to examine the relationship between the prescription of psychotropics and suicide rates. The main findings of this study were: (i) a highly significant negative correlation between the prescription of tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs) and elderly suicide rates; (ii) a significant positive correlation between the prescription of monoamine oxidase inhibitors (MAOIs) and elderly suicide rates; (iii) a highly significant negative correlation between the prescription of antimanics and antipsychotics and elderly suicide rates; (iv) a highly significant positive correlation between the prescription of hypnotics, anxiolytics and barbiturates and elderly suicide rates; and, (v) a significant negative correlation between the prescription of analgesics and elderly suicide rates. A trend of decline in suicide rates in the elderly in England and Wales for 1985 to 1996 and changes in the prescribing of psychotropics were significantly associated. The results of this study suggest that prescription patterns of psychotropics may be an important factor contributing to the recent decline in suicide rates in the elderly in England and Wales but this effect should be viewed in the context of other health and social factors.