ArticlePloS one2013
Antidepressant Utilization and Suicide in Europe: An Ecological Multi-National Study.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 138 citations in OpenAlex.
- Pooled it
- Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults.The Cochrane database of systematic reviews · 2021Pooled it
- The clinical effectiveness of sertraline in primary care and the role of depression severity and duration (PANDA): a pragmatic, double-blind, placebo-controlled randomised trial.The lancet. Psychiatry · 2019Trial
- Trial
- A longitudinal study of suicidal ideation among homeless, mentally ill individuals.Social psychiatry and psychiatric epidemiology · 2016Trial
- Exploring the Lived Experiences of Iranian Adolescents Exhibiting Suicidal Behavior and Ideation.Research on child and adolescent psychopathology · 2025Article
- Pharmacologic Approaches to Suicide Prevention.Focus (American Psychiatric Publishing) · 2023Review
- Association between psychotropic drug prescription and suicide rates in Scotland: population study.BJPsych bulletin · 2023Article
- Implementing Evidence-Based Suicide Prevention Strategies for Greatest Impact.Focus (American Psychiatric Publishing) · 2023Review
- Utilization of psychotropic medicines in Romania during 1998-2018.Frontiers in pharmacology · 2023Article
- Article
- Achieving health equity in US suicides: a narrative review and commentary.BMC public health · 2022Review
- The Toxicity Potential of Antidepressants and Antipsychotics in Relation to Other Medication and Alcohol: A Naturalistic and Retrospective Study.Frontiers in psychiatry · 2022Article
- Factors Contributing to Self-Medication and Consumption of Non-Prescribed Drugs in Portugal.International journal of public health · 2022Article
- Did the introduction and increased prescribing of antidepressants lead to changes in long-term trends of suicide rates?European journal of public health · 2021Article
- Psychotropic and anti-epileptic drug use, before and after surgery, among patients with low-grade glioma: a nationwide matched cohort study.BMC cancer · 2021Article
- Characteristics of completed suicides after Greek financial crisis onset: A comparative time-series analysis study.Social psychiatry and psychiatric epidemiology · 2021Article
- Use of sequence analysis for classifying individual antidepressant trajectories to monitor population mental health.BMC psychiatry · 2020Article
- Reflections on causes of suicidal behaviour.Epidemiology and psychiatric sciences · 2019Article
- Toxicological findings in suicides - frequency of antidepressant and antipsychotic substances.Forensic science, medicine, and pathology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 8 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundResearch concerning the association between use of antidepressants and incidence of suicide has yielded inconsistent results and is the subject of considerable controversy. The first aim is to describe trends in the use of antidepressants and rates of suicide in Europe, adjusted for gross domestic product, alcohol consumption, unemployment, and divorce. The second aim is to explore if any observed reduction in the rate of suicide in different European countries preceded the trend for increased use of antidepressants.
methodsData were obtained for 29 European countries between 1980 and 2009. Pearson correlations were used to explore the direction and magnitude of associations. Generalized linear mixed models and Poisson regression distribution were used to clarify the effects of antidepressants on suicide rates, while an autoregressive adjusted model was used to test the interaction between antidepressant utilization and suicide over two time periods: 1980-1994 and 1995-2009.
findingsAn inverse correlation was observed in all countries between recorded Standardised Death Rate (SDR) for suicide and antidepressant Defined Daily Dosage (DDD), with the exception of Portugal. Variability was marked in the association between suicide and alcohol, unemployment and divorce, with countries depicting either a positive or a negative correlation with the SDR for suicide. Every unit increase in DDD of an antidepressant per 1000 people per day, adjusted for these confounding factors, reduces the SDR by 0.088. The correlation between DDD and suicide related SDR was negative in both time periods considered, albeit more pronounced between 1980 and 1994.
conclusionsSuicide rates have tended to decrease more in European countries where there has been a greater increase in the use of antidepressants. These findings underline the importance of the appropriate use of antidepressants as part of routine care for people diagnosed with depression, therefore reducing the risk of suicide.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.