Antidepressants and Suicide: 7,829 Inquests in England and Wales, 2003–2020

Abstract

Background:Antidepressant (AD) medications increase suicidality for some, or all, age groups. Some, or all, types of ADs, are frequently used in suicides involving overdoses.Methods:The article examines a previously unanalyzed data set summarizing 7,829 media reports of Coroners’ inquests in England and Wales that mention ADs, between 2003 and 2020.Results:The most frequently cited ADs were SSRIs (48.9%) and tricyclics (24.6%). The specific drugs cited most often were the SSRI drug citalopram (19.8%) and the tricyclic drug amitriptyline (17.5%). Of 2,329 cases of death by overdose, 933 (40.1%) were overdoses of ADs, 512 of which (54.9%) did not involve other substances. The ADs most frequently named were amitriptyline (186), and citalopram (86). A further 929 were overdoses of unnamed medicines, a proportion of which may have been ADs.Limitations:The data set, which relies primarily on archives of local newspapers, is incomplete and therefore underestimates the total numbers involved. The accuracy of coroners’ verdicts is not perfect.Conclusions:If preventing suicide is a primary reason for prescribing ADs, this data set includes several thousand people for whom the drugs clearly did not work. Furthermore, about 1,000 people used the drugs that were supposed to alleviate their depression to kill themselves. Systematic analyses of all inquests would be more informative. Meanwhile, reducing the overprescribing of these relatively ineffective and, for some, lethally dangerous substances is suggested, to reduce suicides.