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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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.

OriginalsprogEngelsk
TidsskriftJournal of Affective Disorders
Vol/bind119
Udgave nummer1-3
Sider (fra-til)194-9
Antal sider6
ISSN0165-0327
DOI
StatusUdgivet - dec. 2009

Fingeraftryk

Registries
Prescriptions
Propensity Score
Pharmacies
Denmark
Case-Control Studies
Regression Analysis
Depression

Citer dette

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title = "Early discontinuation of antidepressant treatment and suicide risk among persons aged 50 and over: a population-based register study",
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.",
keywords = "Age Factors, Antidepressive Agents, Denmark, Female, Humans, Male, Middle Aged, Patient Compliance, Proportional Hazards Models, Prospective Studies, Risk Factors, Sex Factors, Suicide",
author = "Annette Erlangsen and Esben Agerbo and Keith Hawton and Yeates Conwell",
year = "2009",
month = "12",
doi = "10.1016/j.jad.2009.03.011",
language = "English",
volume = "119",
pages = "194--9",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
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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.

I: Journal of Affective Disorders, Bind 119, Nr. 1-3, 12.2009, s. 194-9.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Early discontinuation of antidepressant treatment and suicide risk among persons aged 50 and over

T2 - a population-based register study

AU - Erlangsen, Annette

AU - Agerbo, Esben

AU - Hawton, Keith

AU - Conwell, Yeates

PY - 2009/12

Y1 - 2009/12

N2 - 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.

AB - 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.

KW - Age Factors

KW - Antidepressive Agents

KW - Denmark

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Compliance

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Risk Factors

KW - Sex Factors

KW - Suicide

U2 - 10.1016/j.jad.2009.03.011

DO - 10.1016/j.jad.2009.03.011

M3 - Journal article

C2 - 19376594

VL - 119

SP - 194

EP - 199

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

IS - 1-3

ER -