Antidepressant drugs and teenage suicide in Hungary: Time trend and seasonality analysis

Abstract

Objective. The aim of the present study was to analyze the relationship between increasing utilization of antidepressants and lithium, and suicide rate of persons less than 20 years of age in Hungary, with particular regard to seasonal patterns. Methods. Time trend analysis was carried out to determine the correlation between antidepressant and lithium prescription patterns in Hungarian persons under age of 20 years as well as seasonal variations within the study period from January 1998 to December 2006. Results. There was a significant correlation (P = 0.03) between the eight-fold increase in antidepressant + lithium prescriptions and decreasing suicides in young Hungarian people under 20 years of age within the study period. Lithium, selective serotonin reuptake inhibitors (SSRIs) and the group of “other antidepressant drugs” rather than nonselective monoamine reuptake inhibitors and monoamine oxidase-A inhibitors were responsible for this association. No significant association could be drawn from seasonal variation with boys (P = 0.964), girls (P = 0.140), or both genders (P = 0.997). Limitation. Ecological study design. Conclusion. Our findings are in good agreement with large-scale ecological studies showing that the beneficial effect of more widely used antidepressants at a given point could appear on the level of suicide rate of the general population even among patients under the age of 20 years.

Key words::

• Antidepressant agents
• lithium
• suicide
• seasonality
• children and adolescents
• Food and Drug Administration (FDA)

Acknowledgements

The writers of this paper would like to acknowledge the kind help of the following people:

1. Ede Frecska; the Head, Department of Psychiatry, University of Debrecen Medical and Health Science Center, for allowing us access to the department and taking us through the clinical practice of Psychiatry with particular enlightenment on the issue of suicide and antidepressant use in Hungary.

2. Aniko Egerhazi; Attending Psychiatrist, University of Debrecen Medical and Health Science Center, for taking out time to explain the intricate details in the physiology of depression and its management.

3. Attila Nagy; Lecturer in the Department of Epidemiology, University of Debrecen Medical and Health Science Center, for his time and effort in proofreading this paper.

4. Roza Adany; Dean School of Public Health, University of Debrecen Medical and Health Science Center, for her guidance and encouragement throughout the course of this research.

Statement of interest

In the last 5 years Dr. Rihmer has received speaker honoraria from AstraZeneca, Eli Lilly, Krka, Lundbeck, Organon, Pfizer, Richter Gedeon Ltd., Sanofi-Aventis, Schering-Plough, Servier-EGIS, Solvay-Pharma, TEVA, and Wörwag Pharma. He was a member of scientific advisory boards of AstraZeneca, Eli Lilly and Co., Organon, Richer Gedeon Ltd., Sanofi-Aventis, Shering-Plough, Servier-EGIS, and TEVA. Other authors declare no conflict of interest.