Carlsten A, Waern M, Allebeck P
Department of Social Medicine, University of Gothenburg, Vasa Hospital, Sweden.
Soc Psychiatry Psychiatr Epidemiol. 1999 Nov;34(11):609-14. doi: 10.1007/s001270050182.
Previous studies have shown an association between the rates of suicide employing certain types of medications and the availability of those drugs. During recent years, prescription patterns of psychoactive drugs commonly used in suicides have undergone some major changes. This study examines whether altered prescription patterns are associated with changes in the rates of drug-related suicides in the elderly.
An ecological study was performed, in which rates of suicide by drug poisoning were related to prescription sales of different psychotropic drugs, derived from the National Prescription Survey (1987-1996).
Benzodiazepines were the dominant drug type used by elderly persons who committed suicide by drug poisoning. Rates of suicide using benzodiazepines increased despite decreasing prescription sales. Decreasing tricyclic antidepressant sales and increasing SSRI (selective serotonin reuptake inhibitors) sales were paralleled by decreasing rates of suicides employing antidepressants. The fatality ratio (FR) decreased for the antidepressant group, increased for benzodiazepines and remained more or less unchanged for analgesics among the elderly during the study period.
Rates of suicide using benzodiazepines increased in the elderly despite decreasing prescription sales. Benzodiazepines should be prescribed restrictively to this age group.
先前的研究表明，使用某些类型药物的自杀率与这些药物的可获得性之间存在关联。近年来，常用于自杀的精神活性药物的处方模式发生了一些重大变化。本研究调查了处方模式的改变是否与老年人药物相关自杀率的变化有关。
进行了一项生态学研究，其中药物中毒自杀率与从国家处方调查（1987 - 1996年）得出的不同精神药物的处方销售量相关。
苯二氮䓬类药物是药物中毒自杀的老年人使用的主要药物类型。尽管处方销售量下降，但使用苯二氮䓬类药物的自杀率仍有所上升。三环类抗抑郁药销售量下降，选择性5-羟色胺再摄取抑制剂（SSRI）销售量上升，与此同时，使用抗抑郁药的自杀率下降。在研究期间，老年人中抗抑郁药组的致死率（FR）下降，苯二氮䓬类药物组的致死率上升，镇痛药组的致死率或多或少保持不变。
尽管处方销售量下降，但老年人中使用苯二氮䓬类药物的自杀率仍有所上升。应限制对该年龄组开具苯二氮䓬类药物的处方。
