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Antidepressants linked to lower suicide risk among 75+ in residential care


Lower suicide risk was seen in older adults aged 75+ residing in long-term care facilities who were prescribed antidepressants. Suicide risk was doubled in those who were on medication for sleep problems according to a study published in International Journal of Geriatric Psychiatry.

Despite the increasing number of older people who need long-term care and who often experience stressful life transitions and psychiatric conditions that increase risk of self-harm, very little research has focused on suicide in this setting.

Antidepressants are widely used in care facilities for older persons and concerns have been expressed about possible suicidogenic effects of these drugs. Sahlgrenska Suicide Studies, a research group within AgeCap, Centre for Ageing and Health at the University of Gothenburg, conducted a large national cohort study to investigate use of psychoactive medications and suicide risk risk in older adults residing in long-term care facilities.

Antidepressants seemed to protect

The research linked national population registers and included a cohort of over 280,000 Swedish residents aged 75 years and above who were residing in a long-term care facility and followed for up to nine years.

During that period, 110 persons (64 men and 46 women) died by suicide. Half of these deaths occurred during the first year of residence. Suicide risk was lower in long-term care facility residents who were on antidepressants.

“This result suggests a positive effect of antidepressant medication in older adults who live in long term care facilities, but more research is needed to better elucidate this association” says Dr. Khedidja Hedna, first and corresponding author.

Early recognition and quality care

Suicide risk was doubled in those who were taking medication for sleep problems, and fifteen-fold higher in those with a previous episode of self-harm. The research highlights the need for long term care staff to be aware of residents' history to improve early recognition and to adequately monitor the mental health of persons in need of extra support.

“Our findings provide an impetus to improve the quality of care provided to older adults in long-term care. More can be done to improve the mental health of older persons with residential care” says Prof. Margda Waern, who headed up the study.

Khedidja Hedna and Margda Waern, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg.
Photo: Kristina Båth och Johan Wingborg

Title: Psychoactive medication use and risk of suicide in long-term care facility residents