Do Anti-Depressants Decrease Suicide?

This is an obviously important question on many fronts, especially since SSRI’s are among the most heavily prescribed drugs in the world, and because their safety and efficacy have lately been seriously questioned.

So it would be helpful to know if, at the very least, anti-depressants decrease the probability of suicide. In this new working paper, Jens Ludwig, Dave E. Marcotte, and Karen Norberg conclude that they do indeed. Here’s how they arrived at this conclusion:

While there are plausible clinical and behavioral arguments that SSRI’s could have either positive or negative effects on suicide, randomized clinical trials have not been very informative because of small samples and other problems. In this paper we use data from 26 countries for up to 25 years to estimate the effect of SSRI sales on suicide mortality using just the variation in SSRI sales that can be explained by cross-country variation in the growth of drug sales more generally. We find that an increase in SSRI sales of 1 pill per capita (about a 12 percent increase over 2000 sales levels) is associated with a decline in suicide mortality of around 5 percent.

Suicide is, to me, a fascinating subject. Consider the simple fact that there are nearly twice as many suicides in the U.S. each year as there are homicides. And that is the official suicide count, which I am sure is significantly underreported since some suicides are, for a variety of reasons, categorized instead as accidental deaths. But I am guessing that most people worry a lot more about a loved one being murdered than committing suicide.