Discontinuation of antidepressants in suicides findings from the Friuli Venezia Giulia Region, Italy, 2005-2014

Although continued use of antidepressants (AD) has been found to be associated with a lower risk of suicide, AD discontinuation is reported repeatedly. The aim of this case-control study, thus, was to assess whether discontinuation to AD was associated with an increased risk of suicide, according to different genders and age groups. The Social and Health Information System of Friuli Venezia Giulia Region, Italy, was used to collect data on suicides, diagnoses and AD use from 2005 to 2014. We selected, as cases, all suicides that had at least one prescription of AD in the 730 days before death (N = 876), and we matched with regard to age and sex each case with five controls from the general population. Conditional logistic regression analyses were used to assess the association between suicide and modifications of AD treatment. We found that 70% of suicides and controls from the general population discontinued AD in the 2 years before the index date. In two-thirds of them, discontinuations were two or more. Discontinuation of AD, however, did not represent a significant risk factor for suicide. More appropriate care of depression, particularly by primary care physicians who widely prescribe AD, should be fostered in order to prevent suicide. However, more research is needed to assess to which extent AD discontinuation can affect suicidal risk.