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Antidepressants / Mood-stabilizing Treatment and Risk of Suicide -a pharmacoepidemiological study

Lars Søndergård  


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Accepted by: Health Sciences Copenhagen
Defended on: June 28, 2007
Official opponents: Merete Nordentoft , Per Kragh-Sørensen , Göran Isacsson
Tutors: Lars Vedel Kessing , Tom Bolwig

Published in the PhD Database: August 29, 2007


English abstract
Affective disorders are associated with a highly increased risk of suicide. It is reasonable to assume that the introduction of newer antidepressant pharmacotherapy and mood-stabilizing treatment, respectively, relieves depression and probably prevents suicide.
Concordantly, an increasing purchase of antidepressants, SSRIs especially, has coincided with a decreasing suicide rate in most developed countries. Nevertheless, it is uncertain whether this coincidence on the aggregate level reflects a causative preventive effect on the individual level.
Furthermore, warnings have been issued about a probable suicidogenic effect of SSRIs in children and adolescents.

This PhD thesis aims to elucidate a putative association between antidepressants / mood-stabilizing treatment and suicide by using individualised pharmacoepidemiological data.



Danish abstract
Affektive sindslidelser er forbundet med en markant øget selvmordsrisiko og det er nærliggende at antage, at introduktionen af nyere psykofarmakologisk antidepressiv behandling såvel som stemningsstabiliserende medicin ikke blot mildner depression, men også forebygger selvmord. I overensstemmelse hermed er der i de fleste industrialiserede lande konstateret et stigende forbrug af antidepressiva især SSRI-præparater samtidigt med en markant faldende selvmordsrate. Det er imidlertid uafklaret om denne koincidens på populationsniveau afspejler en kausalitet på individniveau. Hertil er det blandt børn og unge foreslået, at behandling med SSRI kan udløse selvmordsadfærd.

Det er afhandlingens formål ved hjælp af individualiserede farmakoepidemiologiske data at belyse en mulig association mellem selvmord og antidepressiv / stemningsstabiliserende behandling.