Early discontinuation of antidepressant treatment and suicide risk among persons aged 50 and over

A population-based register study

Annette Erlangsen, Esben Agerbo, Keith Hawton, Yeates Conwell

Research output: Contribution to journalArticle

Abstract

Background: As many as 47% of adults over age 50 discontinue treatment with antidepressants after redeeming only one prescription. The study aim was to assess the risk of suicide in adults aged 50+ who discontinue antidepressants at an early stage of treatment. Method: Case control study of all individuals aged 50+ living in Denmark and who initiated antidepressant treatment between July 1st 1995 and December 31st 2000 (N = 217,123). Hazard ratios were calculated using Cox regression analyses, propensity score matching techniques, and marginal structural models. Results: During the study period, 78,594 men and 138,529 women aged 50+ began treatment with an antidepressant medication, of whom 309 men and 229 women died by suicide. Men aged 50+ who discontinued treatment early had a suicide rate of 167 per 100,000 compared with 175 per 100,000 in those who continued refilling prescriptions; hazard ratio = 0.98 [CI-95%: 0.78-1.23]. The suicide rate in women who discontinued treatment was 52 per 100,000 compared with 74 per 100,000 in those who continued refilling; hazard ratio = 0.72 [CI-95%: 0.55-0.94]. Although people with previous psychiatric hospitalizations had greater risk of suicide than those without past hospital admissions, the difference was not significant in the adjusted model. Limitations: Prescriptions redeemed at pharmacies are our only indicator of treatment adherence. Also, information on severity of depression was not available. Conclusions: We did not find a lower suicide risk among people over age 50 who seemingly follow treatment in comparison with those who discontinued treatment with antidepressants at an early stage.

Original languageEnglish (US)
Pages (from-to)194-199
Number of pages6
JournalJournal of Affective Disorders
Volume119
Issue number1-3
DOIs
StatePublished - Jan 2009

Fingerprint

Suicide
Antidepressive Agents
Registries
Prescriptions
Therapeutics
Propensity Score
Pharmacies
Structural Models
Denmark
Psychiatry
Case-Control Studies
Hospitalization
Regression Analysis
Depression

Keywords

  • Aged
  • Antidepressants
  • Denmark
  • Non-compliance
  • Suicide

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Early discontinuation of antidepressant treatment and suicide risk among persons aged 50 and over : A population-based register study. / Erlangsen, Annette; Agerbo, Esben; Hawton, Keith; Conwell, Yeates.

In: Journal of Affective Disorders, Vol. 119, No. 1-3, 01.2009, p. 194-199.

Research output: Contribution to journalArticle

Erlangsen, Annette ; Agerbo, Esben ; Hawton, Keith ; Conwell, Yeates. / Early discontinuation of antidepressant treatment and suicide risk among persons aged 50 and over : A population-based register study. In: Journal of Affective Disorders. 2009 ; Vol. 119, No. 1-3. pp. 194-199.
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