Isacsson G, Holmgren P, Druid H, Bergman U
Department of Clinical Neurosciences and Family Medicine, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden.
Acta Psychiatr Scand. 1997 Aug;96(2):94-100. doi: 10.1111/j.1600-0447.1997.tb09912.x.
Antidepressants detected by the National Department of Forensic Chemistry in 5281 suicides in Sweden during the period 1992-1994 were related to data on usage expressed in person-years of exposure. Antidepressants were detected in 874 subjects (16.5%). In relation to their use, fluvoxamine, citalopram, moclobemide, mianserin and trimipramine were found more often than the reference drug, amitriptyline (i.e. over-risks). Toxic concentrations of antidepressants were detected in 232 subjects (4.4%). Most people committing suicide were not taking antidepressants immediately before their death, even though 40-85% may have been depressed. Undertreatment and therapeutic failure are the main problems with antidepressants, not the risk of using antidepressants in overdose. Comparisons of new antidepressants should focus on efficacy in relation to reference tricyclics. The huge increase in the use of antidepressants in Sweden since 1990-1991 has been paralleled by a significant decrease in suicide rates.
瑞典国家法医化学部在1992年至1994年期间检测的5281例自杀案例中的抗抑郁药与以暴露人年表示的使用数据相关。在874名受试者（16.5%）中检测到了抗抑郁药。与使用情况相关，发现氟伏沙明、西酞普兰、吗氯贝胺、米安色林和曲米帕明比参比药物阿米替林出现得更频繁（即风险过高）。在232名受试者（4.4%）中检测到了抗抑郁药的中毒浓度。大多数自杀者在死亡前并未立即服用抗抑郁药，尽管40%至85%的人可能患有抑郁症。抗抑郁药的主要问题是治疗不足和治疗失败，而非过量使用的风险。新型抗抑郁药的比较应聚焦于与参比三环类药物相比的疗效。自1990 - 1991年以来，瑞典抗抑郁药使用量的大幅增加与自杀率的显著下降同时出现。
