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首页> 外文期刊>The journal of clinical psychiatry >Antidepressants and suicide risk in the United States, 1985-1999.
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Antidepressants and suicide risk in the United States, 1985-1999.

机译：1985-1999年，美国的抗抑郁药和自杀风险。

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BACKGROUND: The role of antidepressants in suicide prevention is a major public health question. An association was hypothesized between the increase in the use of non-tricyclic antidepressant medications in the United States and the decline in the suicide rate during the years 1985-1999. METHOD: The relationships between the suicide, antidepressant prescription, unemployment, and alcoholic beverage consumption rates were studied using generalized linear models. Suicide rates by antidepressant overdose were compared in selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). RESULTS: From 1985 to 1999, the suicide rate fell 13.5%, with a greater decline among women, and antidepressant prescription rates increased over 4-fold, with the increase mostly due to SSRIs. Prescription rates for SSRIs and other second-generation antidepressants were both inversely associated with suicide rates (p = .03 and p = .02, respectively). In a multivariable analysis adjusting for unemployment and alcoholic beverage consumption rates, SSRI antidepressant prescription rates remained inversely associated with the national suicide rate (p = .03). Females received twice as many antidepressant prescriptions compared with males. The commonest prescription indication was mood disorders, the condition most often associated with suicide. SSRIs were associated with a lower risk of suicide by antidepressant overdose compared with TCAs. CONCLUSION: The decline in the national suicide rate (1985-1999) appears to be associated with greater use of non-tricyclic antidepressants. Treatment of a greater proportion of mood disorders with SSRIs and other second-generation non-tricyclic antidepressants may further reduce the suicide rate. Controlled studies of the antisuicidal properties of antidepressants are needed in high-risk depressed patient populations.
机译：背景：抗抑郁药在预防自杀中的作用是一个主要的公共卫生问题。据推测，在美国，非三环类抗抑郁药的使用增加与1985-1999年期间的自杀率下降之间存在关联。方法：使用广义线性模型研究自杀，抗抑郁药处方，失业和酒精饮料消费率之间的关系。比较了选择性5-羟色胺再摄取抑制剂（SSRIs）和三环类抗抑郁药（TCA）中抗抑郁药过量引起的自杀率。结果：从1985年到1999年，自杀率下降了13.5％，其中女性的下降幅度更大，抗抑郁药的处方率上升了4倍以上，上升的主要原因是SSRIs。 SSRI和其他第二代抗抑郁药的处方率均与自杀率呈负相关（分别为p = .03和p = .02）。在对失业率和酒精饮料消费率进行调整的多变量分析中，SSRI抗抑郁药处方率与全国自杀率呈负相关（p = .03）。女性服用抗抑郁药的处方数量是男性的两倍。最常见的处方适应症是情绪障碍，最常与自杀有关。与TCA相比，SSRIs与抗抑郁药过量引起的自杀风险较低。结论：全国自杀率的下降（1985-1999年）似乎与非三环类抗抑郁药的大量使用有关。用SSRI和其他第二代非三环抗抑郁药治疗更大比例的情绪障碍可能会进一步降低自杀率。在高风险的抑郁症患者人群中需要对抗抑郁药的抗自杀特性进行对照研究。

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