Initiation and Discontinuation of Psychotropic Drugs Relative to Suicidal Behavior: A Danish Registry-Based Study

INTRODUCTION: Changes in psychotropic drug use relative to suicidal behavior could potentially inform the timing of preventive efforts. We aimed to describe the initiation and discontinuation of psychotropic drugs relative to suicide and suicide attempts.

METHODS: The Danish registries were used to describe incidents and prevalent use of psychotropic drugs 2 years before and after a suicide attempt and before suicide. Discontinuation of psychotropic drugs in the 6-month period prior to suicide and suicide attempts was estimated. Analyses were stratified by drug groups, sex, and age.

RESULTS: Among 5.8 million Danish citizens(2021), 6374 died by suicide, and 29,332 had a first-ever suicide attempt from 2010 to 2021. Use of psychotropic drugs increased markedly in the 6 months prior to suicide and suicide attempt, e.g., up to 18 incident drug redemptions and 92 prevalent drug redemptions per 100 persons in the month before suicide. The highest rates of both incident and prevalent drug redemptions were observed immediately after the suicide attempt. Psychotropic drug use was generally lower among men. Immediately after the suicide attempt, however, men exhibited a slightly higher level of incident use than women. Ten percent discontinued psychotropic drugs completely in the 6-month period before suicide, while 48% discontinued drugs used in alcohol abuse.

CONCLUSION: We found a marked increase in psychotropic drug use before suicide and before and after attempted suicide. Complete pre-attempt discontinuation of psychotropic drugs was low, though approximately half discontinued drugs used for alcohol abuse. The process of prescribing psychotropic drugs may represent an opportunity for prevention.