BACKGROUND: It is generally acknowledged that depressed patients need specific attention during the first weeks after initiation of antidepressant (AD) treatment because of the increased risk of suicide. METHODS: The study population consisted of all individuals residing in Finland from 1999 to 2003 who had purchased a prescribed antidepressant at least once but had no preceding antidepressant prescription. Data sources were the National Prescription Register, the Causes of Death Register, Census Data of Statistics Finland, and the National Care Register. Follow-up started at the first purchase and ended at the end of 2003 or death. Data on prescriptions were used to construct contiguous treatment periods of follow-up time. Life-table analysis with Poisson regression was used to estimate risk ratios (RR) of antidepressant use with respect to all-cause mortality and to deaths from suicide. FINDINGS: Current AD use was associated with a lowered all-cause mortality (RR = 0.18, 95% CI = 0.18-0.19) compared with those who filled one previous prescription only. There was no difference in suicide mortality when any current antidepressant usage was compared to the one-prescription group. Current SSRI usage was associated with lower risk of suicide compared to the one-prescription or other antidepressant groups (RR 0.47, 0.38-0.59). INTERPRETATION: Current AD treatment is associated with decreased all-cause mortality rates in patients who have ever had AD treatment.
BACKGROUND: It is generally acknowledged that depressedpatients need specific attention during the first weeks after initiation of antidepressant (AD) treatment because of the increased risk of suicide. METHODS: The study population consisted of all individuals residing in Finland from 1999 to 2003 who had purchased a prescribed antidepressant at least once but had no preceding antidepressant prescription. Data sources were the National Prescription Register, the Causes of Death Register, Census Data of Statistics Finland, and the National Care Register. Follow-up started at the first purchase and ended at the end of 2003 or death. Data on prescriptions were used to construct contiguous treatment periods of follow-up time. Life-table analysis with Poisson regression was used to estimate risk ratios (RR) of antidepressant use with respect to all-cause mortality and to deaths from suicide. FINDINGS: Current AD use was associated with a lowered all-cause mortality (RR = 0.18, 95% CI = 0.18-0.19) compared with those who filled one previous prescription only. There was no difference in suicide mortality when any current antidepressant usage was compared to the one-prescription group. Current SSRI usage was associated with lower risk of suicide compared to the one-prescription or other antidepressant groups (RR 0.47, 0.38-0.59). INTERPRETATION: Current AD treatment is associated with decreased all-cause mortality rates in patients who have ever had AD treatment.
Authors: Mika Kivimäki; David Gunnell; Debbie A Lawlor; George Davey Smith; Jaana Pentti; Marianna Virtanen; Marko Elovainio; Timo Klaukka; Jussi Vahtera Journal: Psychol Med Date: 2006-11-23 Impact factor: 7.723