Department of Suicide Research and Prevention, Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
BMC Psychiatry. 2010 Aug 6;10:62. doi: 10.1186/1471-244X-10-62.
In the period 1990-2006, strong and almost equivalent increases in sales figures of selective serotonin re-uptake inhibitors (SSRIs) were observed in all Nordic countries. The sales figures of tricyclic antidepressants (TCAs) dropped in Norway and Sweden in the nineties. After 2000, sales figures of TCAs have been almost constant in all Nordic countries. The potentially toxic effect of TCAs in overdose was an important reason for replacing TCAs with SSRIs when treating depression. We studied whether the rapid increase in sales of SSRIs and the corresponding decline in TCAs in the period 1990-98 were associated with a decline in suicide rates.
Aggregated suicide rates for the period 1975-2006 in four Nordic countries (Denmark, Finland, Norway and Sweden) were obtained from the national causes-of-death registries. The sales figures of antidepressants were provided from the wholesale registers in each of the Nordic countries. Data were analysed using Fisher's exact test and Pearson's correlation coefficient.
There was no statistical association (P = 1.0) between the increase of sales figures of SSRIs and the decline in suicide rates. There was no statistical association (P = 1.0) between the decrease in the sale figures of TCAs and change in suicide rates either.
We found no evidence for the rapid increase in use of SSRIs and the corresponding decline in sales of TCAs being associated with a decline in the suicide rates in the Nordic countries in the period 1990-98. We did not find any inverse relationship between the increase in sales of SSRIs and declining suicide rates in four Nordic countries.
1990 年至 2006 年期间，所有北欧国家的选择性 5-羟色胺再摄取抑制剂（SSRIs）销售量都呈强劲且几乎相当的增长态势。90 年代，挪威和瑞典的三环类抗抑郁药（TCAs）销售量有所下降。2000 年后，所有北欧国家 TCAs 的销售量几乎保持不变。在治疗抑郁症时，用 SSRIs 替代 TCAs 的一个重要原因是 TCAs 过量具有潜在的毒性作用。我们研究了 1990 年至 98 年期间 SSRIs 销售量的迅速增加和 TCAs 相应减少是否与自杀率的下降有关。
从四个北欧国家（丹麦、芬兰、挪威和瑞典）的国家死因登记处获得了 1975 年至 2006 年期间的综合自杀率数据。从每个北欧国家的批发登记处获得了抗抑郁药的销售数据。使用 Fisher 确切检验和 Pearson 相关系数进行数据分析。
SSRIs 销售量的增加与自杀率的下降之间没有统计学关联（P = 1.0）。TCAs 销售额的下降与自杀率的变化之间也没有统计学关联（P = 1.0）。
我们没有发现 SSRIs 使用量的迅速增加和 TCAs 销售量的相应下降与 1990 年至 98 年期间北欧国家自杀率下降有关的证据。我们没有发现四个北欧国家 SSRIs 销售额的增加与自杀率下降之间存在任何反相关关系。
