Antidepressant Drug Consumption and Public Health Indicators in Italy, 1955 to 2000
J Clin Psychiatry 2005;66(6):750-755
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Objective: This study investigated the impact of
the increasing consumption of selective serotonin reuptake
inhibitors (SSRIs) and newer antidepressants on the following
public health indicators: (1) suicide rates, (2) proportion of
completed suicides by poisoning with solid or liquid substances,
and (3) hospital admissions for depression and proportion of
admissions for depression that were first admissions.
Method: Data collected by IMS Health on
antidepressants dispensed in Italy from 1983 to 2000 were
obtained from the Italian Ministry of Health, while data on
suicide deaths from 1955 to 2000 were obtained from the Italian
National Institute of Statistics.
Results: In Italy from 1983 to 2000, the use of
tricyclic antidepressants remained substantially stable, and the
use of SSRIs and newer agents dramatically increased. In
contrast, suicide rates for males decreased from 1955 to 1974 and
subsequently increased, reaching a peak in 1985 and then
declining. In females, suicide rates remained substantially
stable until 1978. A subsequent increase occurred up to 1985,
followed by a steady decline. Suicide by poisoning using solids
or liquids dropped by nearly 50% from 1986 to 2000. Admissions to
the hospital for depression showed an erratic pattern; however,
no decline was observed. No change was observed in the rate of
first admissions for depression.
Conclusion: Despite a reduction in suicides by
poisoning using solids or liquids, the analysis of long-term
trends in suicide did not suggest that increases in
antidepressant prescribing lie behind recent reductions in
population suicides. Furthermore, in Italy, newer antidepressants
had no impact on the total number of admissions for depression or
on the proportion of all admissions that were first admissions.