Shah Ajit, Lodhi Lubbaba
West London Mental Health NHS Trust, UK.
Med Sci Law. 2005 Apr;45(2):115-20. doi: 10.1258/rsmmsl.45.2.115.
Suicide rates in the elderly have declined in many countries in recent years. This decline has been reported to be associated with increased prescribing of antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), antipsychotics and antimanic drugs and reduced prescribing of barbiturates, hypnotics and sedatives. This study examined the relationship between prescribing patterns of individual psychotropic drugs and suicide rates by specific methods of elderly suicides. There was a negative correlation between the prescription of tricyclic antidepressants, selective serotonin reuptake inhibitors, antipsychotics, antimanic drugs and non-opiate analgesics and a decline in elderly suicide rates due to poisoning by solid and liquid substances, hanging, strangulation and suffocation, drowning, firearms and explosives, and jumping from high places. There was a positive correlation between the prescription of barbiturates, hypnotics and sedatives and elderly suicide rates due to poisoning by solid and liquid substances, hanging, strangulation and suffocation, drowning, firearms and explosives, and jumping from high places. This study demonstrated that changes in prescribing patterns of individual psychotropic drugs do influence elderly suicide rates of the commonly used methods of suicide and suggest that this may be due to more accurate diagnostic-specific prescribing of psychotropic drugs.
近年来,许多国家老年人的自杀率有所下降。据报道,这种下降与抗抑郁药(尤其是选择性5-羟色胺再摄取抑制剂(SSRI))、抗精神病药和抗躁狂药的处方量增加以及巴比妥类药物、催眠药和镇静剂的处方量减少有关。本研究通过老年人自杀的特定方法,探讨了个体精神药物的处方模式与自杀率之间的关系。三环类抗抑郁药、选择性5-羟色胺再摄取抑制剂、抗精神病药、抗躁狂药和非阿片类镇痛药的处方量与因固体和液体物质中毒、上吊、勒死和窒息、溺水、火器和爆炸物以及高处跳下导致的老年人自杀率下降之间存在负相关。巴比妥类药物、催眠药和镇静剂的处方量与因固体和液体物质中毒、上吊、勒死和窒息、溺水、火器和爆炸物以及高处跳下导致的老年人自杀率之间存在正相关。本研究表明,个体精神药物处方模式的变化确实会影响老年人常用自杀方式的自杀率,并表明这可能是由于精神药物的诊断特异性处方更准确所致。