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Journal of Public Health Advance Access originally published online on January 31, 2008
Journal of Public Health 2008 30(1):60-68; doi:10.1093/pubmed/fdm085
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© The Author 2008, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Antidepressant prescribing and changes in antidepressant poisoning mortality and suicide in England, 1993–2004



Oliver Morgan, Honorary Research Associate1,2

Clare Griffiths, Principal Research Officer2,

Azeem Majeed, Chair of Primary Care and Social Medicine and Head of Department1
1 Department of Primary Care and Social Medicine, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
2 Office for National Statistics, UK

Address correspondence to Oliver Morgan, E-mail: omorgan{at}bigfoot.com


  Abstract

Background In England, the impact of increased use of antidepressant medications is unclear. We examine associations between antidepressant use, suicide and antidepressant poisoning mortality, adjusted for important covariates.

Methods Data on suicide and antidepressant poisoning mortality were provided by the Office for National Statistics. Prescription data were provided by the Department of Health. Age- and sex-specific prescribing rates were estimated from The Health Improvement Network primary care data. We measured the association between prescribing, suicide and poisoning mortality after adjusting for age, sex, calendar year, prescribing rates and use of newer antidepressants drugs.

Results The prevalence of antidepressant treatment increased during the 1990s for all age and sex groups. Treatment prevalence remained constant from 2002 but declined among children and adolescents. Between 1993 and 2004, age-standardized rates for suicide decreased from 98.2 to 81.3 per million populations and for antidepressants from 9.2 to 7.4 per million populations. Before adjustment, increased antidepressant prescribing was associated with a decrease in suicide (rs = –0.90, P < 0.001) and antidepressant poisoning mortality rates (rs = –0.65, P = 0.023). This association disappeared after adjustment.

Conclusion In England, at a population level, there does not appear to be an association between antidepressant prescribing and antidepressant poisoning mortality or suicide.

Keywords: antidepressant, poisoning, mortality, prescribing


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