Use of prescription medication prior to suicide in Norway

Abstract

Background The use of psychotropic medications in relation to mental disorders is considered central to preventing suicide. However, few studies have addressed prescription patterns at different time points within the last year prior to suicide and compared these with those of the general population. Methods We use data covering the period from 2010 to 2011 from the Norwegian Cause of Death Registry and the Norwegian Prescription Database to examine dispensing patterns of prescription medication within 12 months and within 30 days of suicide. Our data includes all registered suicides in Norway among individuals aged 15 years and older in 2011 ( n = 594), 434 men and 160 women. Dispensing of prescription medication in the general population (n ≈ 4 million) are used for comparison. Results Dispensing of any prescription medication were high and varied from 95.6% for females and 83.2% for males within 12 months of suicide, to 64.4% for females and 47.2% for males within 30 days of suicide, respectively. The percentages with dispensed prescription medication increased with age. A similar sex and age pattern was observed for the dispensing of psychotropic medications. Within the last 30 days, close to one in two were dispensed psychotropic medications. The dispensing of antidepressants, hypnotics and sedatives was more common than the dispensing of other categories of psychotropics. The percentages with dispensed prescription medication among the population controls were considerably lower, in particular the dispensing of psychotropics. Conclusion Dispensing of prescription medications, including psychotropic medications, is common prior to suicide. The percentage with dispensed prescription medication increases with age and are higher for females than for males.

The association between self-reported mental health, medication record and suicide risk: A population wide study

“…To our knowledge this is the first study to directly compare these two indicators of poor mental health. Our findings agree with earlier studies that separately examined self-reported poor mental health ( Bramness et al, 2010 ; Gunnell et al, 2002 ) and psychotropic medication record ( Isacsson et al, 1999 ; Reneflot et al, 2019 ; Takeuchi et al, 2017 ; Windfuhr et al, 2016 ) and showed them to be important indicators of suicide risk. In our study, the use of two mental health indicators combined (relative to using them separately) offered better precision for identifying individuals at risk of dying by suicide.…”

“…That individuals in receipt of psychotropic medications are at increased risk of suicide has been demonstrated in Norway, Japan and England ( Reneflot et al, 2019 ; Takeuchi et al, 2017 ; Windfuhr et al, 2016 ). Studies have shown that 36–51.7% of suicide decedents were in receipt of prescriptions for psychotropic medication 3 to 12 months before their death ( Appleby et al, 2014 ; Benson et al, 2018 ; Henriksson et al, 2001 ) and a post-mortem toxicological analysis found evidence of psychotropic medication use in nearly half (45.3%) of 5,281 suicides in Sweden ( Isacsson et al, 1999 ).…”

Impact of COVID-19 pandemic and lockdowns on the consumption of anxiolytics, hypnotics and antidepressants according to age groups: a French nationwide study

“…For example, using the Norwegian Prescription Database, it has been shown that patients who died by suicide were dispensed more psychotropic medications than the general population, including antidepressants, anxiolytics and hypnotics, suggesting a higher severity of the depression experienced prior to dying by suicide (Reneflot, Kaspersen, Hauge, & Kalseth, 2019 ). Although prescribing habits may vary over time and space, the increase in treatment dispensations probably reflects improved access to adequate treatment or a deterioration in the mental health of the population, circumstances invite us to monitor these indicators and to develop algorithms to describe and even predict mental health disorders through a pharmaco-epidemiological approach (Bezin et al, 2017 ).…”

Publicações sobre medicamentos psicotrópicos em blogs pessoais

“…Isso pode ser evidenciado nos depoimentos, que mencionam o uso de psicotrópicos, juntamente com o álcool, com propósito de colocar fim a própria vida. Um estudo norueguês examinou os padrões de dispensa de fármacos antes do suicídio, traz dados relevantes, como a dispensa de psicotrópicos trinta dias antes do suicídio, além disso, as categorias de medicamentos PUBLICAÇÕES SOBRE MEDICAMENTOS PSICOTRÓPICOS EM BLOGS PESSOAIS psicotrópicos mais comumente dispensadas foram os hipnóticos, sedativos e os antidepressivos (Reneflot et al, 2019). Desse modo, é preciso atenção para os indivíduos que usam psicotrópicos, mesmo com a prescrição médica, pois pode ocorrer ideação suicida em pacientes que, anterior ao uso da medicação, tiveram uma ou mais tentativas de suicídio, e comportamentos de autolesão, sendo os referidos comportamentos também identificados nas publicações do presente estudo.…”