Age-Related response to redeemed antidepressants measured by completed suicide in older adults

A nationwide cohort study

Annette Erlangsen, Yeates Conwell

Research output: Contribution to journalArticle

Abstract

Objective: To examine if the suicide rate of older adults prescribed antidepressants varies with age and to assess the proportion of older adults who died by suicide that had recently been prescribed antidepressants. Methods: A population-based cohort study using a nationwide linkage of individual-level records was conducted on all persons aged 50 living in Denmark during 1996-2006 (1,215,524 men and 1,343,568 women). Suicide rates by treatment status were calculated using data on all antidepressant prescriptions redeemed at pharmacies. Results: Individual-level data covered 9,354,620 and 10,720,639 person-years for men and women, respectively. Men aged 50-59 who received antidepressants had a mean suicide rate of 185 (95% confidence interval [CI]: 160-211) per 100,000, whereas for those aged 80 the rate was 119 (95% CI: 91-146). For women, the corresponding values were 82 (95% CI: 70-94) and 28 (95% CI: 20-35). Logistic regression showed a 2% and 3% decline in the rate for men and women, respectively, considered in treatment with antidepressants, with each additional year of age. An opposite trend was found for persons not in treatment. Fewer persons aged 80 dying by suicide had received antidepressant prescriptions during the last months of life than younger persons. Conclusion: An age-dependent decline in suicide rate for antidepressant recipients was identified. One reason could be that older adults respond better to antidepressants than younger age groups. Still, the increasing gap with age between estimated prevalence of depression and antidepressant prescription rate in persons dying by suicide underscores the need for assessment of depression in the oldest old.

Original languageEnglish (US)
Pages (from-to)25-33
Number of pages9
JournalAmerican Journal of Geriatric Psychiatry
Volume22
Issue number1
DOIs
StatePublished - Jan 2014

Fingerprint

Suicide
Antidepressive Agents
Cohort Studies
Confidence Intervals
Prescriptions
Depression
Needs Assessment
Pharmacies
Denmark
Therapeutics
Age Groups
Logistic Models
Population

Keywords

  • Aged
  • Antidepressant
  • Elderly
  • Oldest old
  • Suicide

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

Age-Related response to redeemed antidepressants measured by completed suicide in older adults : A nationwide cohort study. / Erlangsen, Annette; Conwell, Yeates.

In: American Journal of Geriatric Psychiatry, Vol. 22, No. 1, 01.2014, p. 25-33.

Research output: Contribution to journalArticle

@article{cc09ed1cdc414d6490c84503b1139f59,
title = "Age-Related response to redeemed antidepressants measured by completed suicide in older adults: A nationwide cohort study",
abstract = "Objective: To examine if the suicide rate of older adults prescribed antidepressants varies with age and to assess the proportion of older adults who died by suicide that had recently been prescribed antidepressants. Methods: A population-based cohort study using a nationwide linkage of individual-level records was conducted on all persons aged 50 living in Denmark during 1996-2006 (1,215,524 men and 1,343,568 women). Suicide rates by treatment status were calculated using data on all antidepressant prescriptions redeemed at pharmacies. Results: Individual-level data covered 9,354,620 and 10,720,639 person-years for men and women, respectively. Men aged 50-59 who received antidepressants had a mean suicide rate of 185 (95{\%} confidence interval [CI]: 160-211) per 100,000, whereas for those aged 80 the rate was 119 (95{\%} CI: 91-146). For women, the corresponding values were 82 (95{\%} CI: 70-94) and 28 (95{\%} CI: 20-35). Logistic regression showed a 2{\%} and 3{\%} decline in the rate for men and women, respectively, considered in treatment with antidepressants, with each additional year of age. An opposite trend was found for persons not in treatment. Fewer persons aged 80 dying by suicide had received antidepressant prescriptions during the last months of life than younger persons. Conclusion: An age-dependent decline in suicide rate for antidepressant recipients was identified. One reason could be that older adults respond better to antidepressants than younger age groups. Still, the increasing gap with age between estimated prevalence of depression and antidepressant prescription rate in persons dying by suicide underscores the need for assessment of depression in the oldest old.",
keywords = "Aged, Antidepressant, Elderly, Oldest old, Suicide",
author = "Annette Erlangsen and Yeates Conwell",
year = "2014",
month = "1",
doi = "10.1016/j.jagp.2012.08.008",
language = "English (US)",
volume = "22",
pages = "25--33",
journal = "American Journal of Geriatric Psychiatry",
issn = "1064-7481",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Age-Related response to redeemed antidepressants measured by completed suicide in older adults

T2 - A nationwide cohort study

AU - Erlangsen, Annette

AU - Conwell, Yeates

PY - 2014/1

Y1 - 2014/1

N2 - Objective: To examine if the suicide rate of older adults prescribed antidepressants varies with age and to assess the proportion of older adults who died by suicide that had recently been prescribed antidepressants. Methods: A population-based cohort study using a nationwide linkage of individual-level records was conducted on all persons aged 50 living in Denmark during 1996-2006 (1,215,524 men and 1,343,568 women). Suicide rates by treatment status were calculated using data on all antidepressant prescriptions redeemed at pharmacies. Results: Individual-level data covered 9,354,620 and 10,720,639 person-years for men and women, respectively. Men aged 50-59 who received antidepressants had a mean suicide rate of 185 (95% confidence interval [CI]: 160-211) per 100,000, whereas for those aged 80 the rate was 119 (95% CI: 91-146). For women, the corresponding values were 82 (95% CI: 70-94) and 28 (95% CI: 20-35). Logistic regression showed a 2% and 3% decline in the rate for men and women, respectively, considered in treatment with antidepressants, with each additional year of age. An opposite trend was found for persons not in treatment. Fewer persons aged 80 dying by suicide had received antidepressant prescriptions during the last months of life than younger persons. Conclusion: An age-dependent decline in suicide rate for antidepressant recipients was identified. One reason could be that older adults respond better to antidepressants than younger age groups. Still, the increasing gap with age between estimated prevalence of depression and antidepressant prescription rate in persons dying by suicide underscores the need for assessment of depression in the oldest old.

AB - Objective: To examine if the suicide rate of older adults prescribed antidepressants varies with age and to assess the proportion of older adults who died by suicide that had recently been prescribed antidepressants. Methods: A population-based cohort study using a nationwide linkage of individual-level records was conducted on all persons aged 50 living in Denmark during 1996-2006 (1,215,524 men and 1,343,568 women). Suicide rates by treatment status were calculated using data on all antidepressant prescriptions redeemed at pharmacies. Results: Individual-level data covered 9,354,620 and 10,720,639 person-years for men and women, respectively. Men aged 50-59 who received antidepressants had a mean suicide rate of 185 (95% confidence interval [CI]: 160-211) per 100,000, whereas for those aged 80 the rate was 119 (95% CI: 91-146). For women, the corresponding values were 82 (95% CI: 70-94) and 28 (95% CI: 20-35). Logistic regression showed a 2% and 3% decline in the rate for men and women, respectively, considered in treatment with antidepressants, with each additional year of age. An opposite trend was found for persons not in treatment. Fewer persons aged 80 dying by suicide had received antidepressant prescriptions during the last months of life than younger persons. Conclusion: An age-dependent decline in suicide rate for antidepressant recipients was identified. One reason could be that older adults respond better to antidepressants than younger age groups. Still, the increasing gap with age between estimated prevalence of depression and antidepressant prescription rate in persons dying by suicide underscores the need for assessment of depression in the oldest old.

KW - Aged

KW - Antidepressant

KW - Elderly

KW - Oldest old

KW - Suicide

UR - http://www.scopus.com/inward/record.url?scp=84893352508&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84893352508&partnerID=8YFLogxK

U2 - 10.1016/j.jagp.2012.08.008

DO - 10.1016/j.jagp.2012.08.008

M3 - Article

VL - 22

SP - 25

EP - 33

JO - American Journal of Geriatric Psychiatry

JF - American Journal of Geriatric Psychiatry

SN - 1064-7481

IS - 1

ER -