Antidepressants and suicide: 7,829 inquests in England and Wales, 2003-2020

Article

Read, J. and White, E. 2023. Antidepressants and suicide: 7,829 inquests in England and Wales, 2003-2020. Ethical Human Psychology and Psychiatry.
AuthorsRead, J. and White, E.
Abstract

Background:
Antidepressant medications increase suicidality for some, or all, age groups. Some, or all, types of antidepressants are frequently used in suicides involving overdoses.

Methods:
The paper examines a previously unanalysed data set summarising 7,829 media reports of Coroners’ Inquests in England and Wales that mention antidepressants, 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. A further 929 were overdoses of unnamed medicines, a proportion of which may have been ADs. The ADs most frequently named were amitriptyline (186), and citalopram (86).

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 antidepressants, this data set includes several thousand people for whom the drugs clearly did not work. 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.

JournalEthical Human Psychology and Psychiatry
ISSN1559-4343
1938-9000
Year2023
PublisherSpringer Publishing Company
Accepted author manuscript
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Publication process dates
Accepted23 Jan 2023
Deposited23 Jan 2023
Copyright holder© 2023 Springer Publishing Company
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From adversity to psychosis: pathways and mechanisms from specific adversities to specific symptoms
Bentall, Richard P., de Sousa, Paulo, Varese, Filippo, Wickham, Sophie, Sitko, Katarzyna, Haarmans, Maria and Read, J. 2014. From adversity to psychosis: pathways and mechanisms from specific adversities to specific symptoms. Social Psychiatry and Psychiatric Epidemiology. 49 (7), pp. 1011-1022. https://doi.org/10.1007/s00127-014-0914-0
Beliefs of people taking antidepressants about causes of depression and reasons for increased prescribing rates
Read, J., Cartwright, Claire, Gibson, Kerry, Shiels, Christopher and Haslam, Nicholas 2014. Beliefs of people taking antidepressants about causes of depression and reasons for increased prescribing rates. Journal of Affective Disorders. 168, pp. 236-242. https://doi.org/10.1016/j.jad.2014.06.010
Patient-Centered Perspectives on Antidepressant Use
Gibson, Kerry, Cartwright, Claire and Read, J. 2014. Patient-Centered Perspectives on Antidepressant Use. International Journal of Mental Health. 43 (1), pp. 81-99. https://doi.org/10.2753/IMH0020-7411430105
Saving psychiatry from itself: will young psychiatrists choose authoritarian power or authoritative respect?
Read, J. 2014. Saving psychiatry from itself: will young psychiatrists choose authoritarian power or authoritative respect? Acta Psychiatrica Scandinavica. 131 (1), pp. 11-12. https://doi.org/10.1111/acps.12355
‘People with Problems, Not Patients with Illnesses’: Using Psychosocial frameworks to Reduce the Stigma of Psychosis
Longdon, Eleanor and Read, J. 2017. ‘People with Problems, Not Patients with Illnesses’: Using Psychosocial frameworks to Reduce the Stigma of Psychosis. Israel Journal of Psychiatry and Related Sciences. 54 (1), pp. 24-30.
“I Believe I Know Better Even than the Psychiatrists What Caused It”: Exploring the Development of Causal Beliefs in People Experiencing Psychosis
Carter, Lucy, Read, J., Pyle, Melissa and Morrison, Anthony 2018. “I Believe I Know Better Even than the Psychiatrists What Caused It”: Exploring the Development of Causal Beliefs in People Experiencing Psychosis. Community Mental Health Journal. https://doi.org/10.1007/s10597-017-0219-3
Ngā Whakāwhitinga (standing at the crossroads): How Māori understand what Western psychiatry calls “schizophrenia”
Taitimu, Melissa, Read, J. and McIntosh, Tracey 2018. Ngā Whakāwhitinga (standing at the crossroads): How Māori understand what Western psychiatry calls “schizophrenia”. Transcultural Psychiatry. 55 (2), pp. 153 -177. https://doi.org/10.1177/1363461518757800
Are Causal Beliefs Associated With Stigma? A Test of the Impact of Biogenetic Versus Psychosocial Explanations on Stigma and Internalized Stigma in People Experiencing Psychosis
Carter, Lucy, Read, J., Pyle, Melissa and Morrison, Anthony P. 2018. Are Causal Beliefs Associated With Stigma? A Test of the Impact of Biogenetic Versus Psychosocial Explanations on Stigma and Internalized Stigma in People Experiencing Psychosis. Stigma and Health. 4 (2), pp. 170-178. https://doi.org/10.1037/sah0000129
Personal agency in women's recovery from depression: The impact of antidepressants and women's personal efforts
Cartwright, Claire, Gibson, Kerry and Read, J. 2018. Personal agency in women's recovery from depression: The impact of antidepressants and women's personal efforts. Clinical Psychologist. 22 (1), pp. 72-82. https://doi.org/10.1111/cp.12093
Making Sense of, and Responding Sensibly to, Psychosis
Read, J. 2018. Making Sense of, and Responding Sensibly to, Psychosis. Journal of Humanistic Psychology. 59 (5), pp. 672-680. https://doi.org/10.1177/0022167818761918
How do mental health services respond when child abuse or neglect become known? A literature review
Read, J., Harper, D., Tucker, I. and Kennedy, Angela 2018. How do mental health services respond when child abuse or neglect become known? A literature review. International Journal of Mental Health Nursing. 27 (6), pp. 1606-1617. https://doi.org/10.1111/inm.12498
How many of 1829 antidepressant users report withdrawal effects or addiction?
Read, J., Cartwright, Claire and Gibson, Kerry 2018. How many of 1829 antidepressant users report withdrawal effects or addiction? International Journal of Mental Health Nursing. 27 (6), pp. 1805-1815. https://doi.org/10.1111/inm.12488
Attempting to stop antipsychotic medication: success, supports, and efforts to cope
Larsen-Barr, Miriam, Seymour, Fred, Read, J. and Gibson, Kerry 2018. Attempting to stop antipsychotic medication: success, supports, and efforts to cope. Social Psychiatry and Psychiatric Epidemiology. 53 (7), pp. 745-756. https://doi.org/10.1007/s00127-018-1518-x
Staying on, and coming off, antidepressants: the experiences of 752 UKadults.
Read, J., Gee, Aimee, Diggle, Jacob and Butler, Helen 2018. Staying on, and coming off, antidepressants: the experiences of 752 UKadults. Addictive Behaviors. 88, pp. 82-85. https://doi.org/10.1016/j.addbeh.2018.08.021
An audit of ECT in England 2011-2015: Usage, demographics, and adherence to guidelines and legislation
Read, J., Harrop, Christopher, Geekie, Jim and Renton, Julia 2018. An audit of ECT in England 2011-2015: Usage, demographics, and adherence to guidelines and legislation. Psychology and Psychotherapy: Theory, Research and Practice. 91 (3), pp. 263-277. https://doi.org/10.1111/papt.12160
Causal beliefs in people experiencing psychosis: The relationship to treatment accessed and the perceived helpfulness of treatment
Carter, Lucy, Read, J., Pyle, Melissa, Law, Heather, Emsley, Richard and Morrison, Anthony 2018. Causal beliefs in people experiencing psychosis: The relationship to treatment accessed and the perceived helpfulness of treatment. Psychology and Psychotherapy: Theory, Research and Practice. 91 (3), pp. 332-344. https://doi.org/10.1111/papt.12163
A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based?
Davies, James and Read, J. 2018. A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Addictive Behaviors. 97, pp. 111-121. https://doi.org/10.1016/j.addbeh.2018.08.027
Adverse Effects of Antidepressants Reported by a Large International Cohort: Emotional Blunting, Suicidality, and Withdrawal Effects
Read, J. and Williams, James 2018. Adverse Effects of Antidepressants Reported by a Large International Cohort: Emotional Blunting, Suicidality, and Withdrawal Effects. Current Drug Safety. 13 (3), pp. 176-186. https://doi.org/10.2174/1574886313666180605095130
Correspondence: Network meta-analysis of antidepressants
Timimi, Sami, Moncrieff, Joanna, Gøtzche, Peter, Davies, James, Kinderman, Peter, Byng, Richard, Montagu, Luke and Read, J. 2018. Correspondence: Network meta-analysis of antidepressants. The Lancet. 392 (10152), pp. 1011-1012. https://doi.org/10.1016/S0140-6736(18)31784-7
Correspondence: Purpose, humility, civility, and science
Kinderman, Peter, Davies, James, Moore, James, Guy, Anne, Read, J., Timimi, Sami and Double, Duncan 2018. Correspondence: Purpose, humility, civility, and science. The Lancet Psychiatry. 5 (12), pp. 964-965. https://doi.org/10.1016/S2215-0366(18)30418-8
The interpersonal adverse effects reported by 1008 users of antidepressants; and the incremental impact of polypharmacy
Read, J., Gee, Aimee, Diggle, Jacob and Butler, Helen 2017. The interpersonal adverse effects reported by 1008 users of antidepressants; and the incremental impact of polypharmacy. Psychiatry Research. 256, pp. 423-427. https://doi.org/10.1016/j.psychres.2017.07.003
Predictors of Staff Attitudes Toward Schizophrenia Treatments
Magliano, Lorenza, Read, J. and Affuso, Gaetana 2017. Predictors of Staff Attitudes Toward Schizophrenia Treatments. Psychiatric Services. 68 (12), pp. 1321-1321. https://doi.org/10.1176/appi.ps.201700257
Testing complex hypotheses using secondary data analysis: is the association between sexual abuse and psychosis moderated by gender in a large prison sample?
Shevlin, Mark, Murphy, Jamie and Read, J. 2015. Testing complex hypotheses using secondary data analysis: is the association between sexual abuse and psychosis moderated by gender in a large prison sample? Journal of Criminal Psychology. 5 (2), pp. 92-98. https://doi.org/10.1108/jcp-02-2015-0009
The Impact of Causal Explanations on Outcome in People Experiencing Psychosis: A Systematic Review
Carter, Lucy, Read, J., Pyle, Melissa and Morrison, Anthony P. 2016. The Impact of Causal Explanations on Outcome in People Experiencing Psychosis: A Systematic Review. Clinical Psychology and Psychotherapy. 24 (2), pp. 332-347. https://doi.org/10.1002/cpp.2002
Mental health clinicians’ beliefs about the causes of psychosis: Differences between professions and relationship to treatment preferences
Carter, Lucy, Morrison, Anthony P., Pyle, Melissa and Read, J. 2017. Mental health clinicians’ beliefs about the causes of psychosis: Differences between professions and relationship to treatment preferences. International Journal of Social Psychiatry. 63 (5), pp. 426-432. https://doi.org/10.1177/0020764017709849
Child abuse in England and Wales 2003–2013: Newspaper reporting versus reality
Davies, Emma, O’Leary, Erin and Read, J. 2015. Child abuse in England and Wales 2003–2013: Newspaper reporting versus reality. Journalism. 18 (6), pp. 754-771. https://doi.org/10.1177/1464884915610994
Conflict in Mens Experiences With Antidepressants
Gibson, K., Cartwright, C. and Read, J. 2016. Conflict in Mens Experiences With Antidepressants. American Journal of Men's Health. 12 (1), pp. 104-116. https://doi.org/10.1177/1557988316637645
‘Learning how to ask’: Effectiveness of a training for trauma inquiry and response in substance use disorder healthcare professionals
Lotzin, A., Buth, S., Sehner, S., Hiller, P., Martens, M., Pawils, S., Metzner, F., Read, J., Härter, M. and Schäfer, I. 2018. ‘Learning how to ask’: Effectiveness of a training for trauma inquiry and response in substance use disorder healthcare professionals. Psychological Trauma: Theory, Research, Practice, and Policy. 10 (2), pp. 229 -238. https://doi.org/10.1037/tra0000269
Childhood adversity and psychosis: generalised or specific effects?
Longden, Eleanor, Sampson, Maria and Read, J. 2015. Childhood adversity and psychosis: generalised or specific effects? Epidemiology and Psychiatric Sciences. 25 (4), pp. 349-359. https://doi.org/10.1017/S204579601500044X
Improving community mental health services: The need for a paradigm shift
Longden, Eleanor, Read, J. and Dillon, Jacqui 2016. Improving community mental health services: The need for a paradigm shift. Israel Journal of Psychiatry and Related Sciences. 53 (1), pp. 22-30.
General practitioners' beliefs about people with schizophrenia and whether they should be subject to discriminatory treatment when in medical hospital: the mediating role of dangerousness perception
Magliano, Lorenza, Punzo, Rosanna, Strino, Antonella, Acone, Roberta and Read, J. 2016. General practitioners' beliefs about people with schizophrenia and whether they should be subject to discriminatory treatment when in medical hospital: the mediating role of dangerousness perception. American Journal of Orthopsychiatry. 87 (5), pp. 559-566. https://doi.org/10.1037/ort0000217
Stressful events and circumstances reported by patients prior to being prescribed antidepressants
Hartdegen, Morgyn, Gibson, Kerry, Cartwright, Claire and Read, J. 2017. Stressful events and circumstances reported by patients prior to being prescribed antidepressants. New Zealand Medical Journal. 130 (1448), pp. 45-53.
Effects of the diagnostic label “schizophrenia”, actively used or passively accepted, on general practitioners’ views of this disorder.
Magliano, Lorenza, Strino, Antonella, Punzo, Rosanna, Acone, Roberta, Affuso, Gaetana and Read, J. 2017. Effects of the diagnostic label “schizophrenia”, actively used or passively accepted, on general practitioners’ views of this disorder. International Journal of Social Psychiatry. 63 (3), pp. 224-234. https://doi.org/10.1177/0020764017695353
Understanding the long-term effects of childhood adversities: Beyond diagnosis and abuse
Read, J. and Mayne, Rachael 2017. Understanding the long-term effects of childhood adversities: Beyond diagnosis and abuse. Journal of Child and Adolescent Trauma. 10 (3), pp. 289-297. https://doi.org/10.1007/s40653-017-0137-0
Is electroconvulsive therapy for depression more effective than placebo? A systematic review of studies since 2009.
Read, J. and Arnold, C. 2017. Is electroconvulsive therapy for depression more effective than placebo? A systematic review of studies since 2009. Ethical Human Psychology and Psychiatry. 19 (1), pp. 5-23. https://doi.org/10.1891/1559-4343.19.1.5
The Opinions of Italian Psychology Students About People Diagnosed with Depression and Schizophrenia: A Comparative Study
Magliano, Lorenza, Schioppa, Giustina, Costanzo, Regina, Petrillo, Miriam and Read, J. 2017. The Opinions of Italian Psychology Students About People Diagnosed with Depression and Schizophrenia: A Comparative Study. Journal of Psychosocial Rehabilitation and Mental Health. 4 (2), pp. 147-157. https://doi.org/10.1007/s40737-017-0087-8
Assessing the Impact and Effectiveness of Hearing Voices Network Self-Help Groups
Longden, Eleanor, Read, J. and Dillon, Jacqui 2017. Assessing the Impact and Effectiveness of Hearing Voices Network Self-Help Groups. Community Mental Health Journal. 54 (2), pp. 184-188. https://doi.org/10.1007/s10597-017-0148-1
Do English mental health services know whether they followed N.I.C.E. guidelines with patients who killed themselves?
Geekie, Jim, Read, J., Renton, Julia and Harrop, Christopher 2017. Do English mental health services know whether they followed N.I.C.E. guidelines with patients who killed themselves? Psychology and Psychotherapy: Theory, Research and Practice. 90 (4), pp. 797-800. https://doi.org/10.1111/papt.12141
Do adult mental health services identify child abuse and neglect? A systematic review
Read, J., Harper, D., Tucker, I. and Kennedy, Angela 2017. Do adult mental health services identify child abuse and neglect? A systematic review. International Journal of Mental Health Nursing. 27 (1), pp. 7-19. https://doi.org/10.1111/inm.12369
Do GPs and psychiatrists recommend alternatives when prescribing anti-depressants?
Read, J., Gibson, Kerry and Cartwright, Claire 2016. Do GPs and psychiatrists recommend alternatives when prescribing anti-depressants? Psychiatry Research. 246 (Dec.), pp. 838-840. https://doi.org/10.1016/j.psychres.2016.10.069
Long-term antidepressant use: patient perspectives of benefits and adverse effects
Cartwright, Claire, Gibson, Kerry, Read, J., Cowan, Ondria and Dehar, Tamsin 2016. Long-term antidepressant use: patient perspectives of benefits and adverse effects. Patient Preference and Adherence. 10, pp. 1401-1407.
Assessing and Reporting the Adverse Effects of Antipsychotic Medication: A Systematic Review of Clinical Studies, and Prospective, Retrospective, and Cross-Sectional Research
Longden, Eleanor and Read, J. 2016. Assessing and Reporting the Adverse Effects of Antipsychotic Medication: A Systematic Review of Clinical Studies, and Prospective, Retrospective, and Cross-Sectional Research. Clinical Neuropharmacology. 39 (1), pp. 29-39.
In search of an evidence-based role for psychiatry
Read, J., Runciman, Olga and Dillon, Jacqui 2016. In search of an evidence-based role for psychiatry. Future Science OA. 2 (1).
Social Adversity in the Etiology of Psychosis: A Review of the Evidence
Longden, Eleanor and Read, J. 2016. Social Adversity in the Etiology of Psychosis: A Review of the Evidence. American Journal of Psychotherapy. 70 (1), pp. 5-33.
Improving Psychology Students’ Attitudes Toward People With Schizophrenia: A Quasi- Randomized Controlled Study.
Magliano, Lorenza, Rinaldi, Angela, Costanzo, Regina, De Leo, Renata, Schioppa, Giustina, Petrillo, Miriam and Read, J. 2016. Improving Psychology Students’ Attitudes Toward People With Schizophrenia: A Quasi- Randomized Controlled Study. American Journal of Orthopsychiatry. 86 (3), pp. 253-264. https://doi.org/10.1037/ort0000161
‘In my life antidepressants have been…’: a qualitative analysis of users’ diverse experiences with antidepressants
Gibson, Kerry, Cartwright, Claire and Read, J. 2016. ‘In my life antidepressants have been…’: a qualitative analysis of users’ diverse experiences with antidepressants. BMC Psychiatry. 16 (1).
The Influence of Causal Explanations and Diagnostic Labeling on Psychology Students’ Beliefs About Treatments, Prognosis, Dangerousness and Unpredictability in Schizophrenia
Magliano, Lorenza, Read, J., Rinaldi, Angela, Costanzo, Regina, De Leo, Renata, Schioppa, Giustina and Petrillo, Miriam 2015. The Influence of Causal Explanations and Diagnostic Labeling on Psychology Students’ Beliefs About Treatments, Prognosis, Dangerousness and Unpredictability in Schizophrenia. Community Mental Health Journal. 52 (3), pp. 361-369.
Are mental health services getting better at responding to abuse, assault and neglect?
Read, J., Sampson, Maria and Critchley, Christine 2016. Are mental health services getting better at responding to abuse, assault and neglect? Acta Psychiatrica Scandinavica. 134 (4), pp. 287-294. https://doi.org/10.1111/acps.12552
Are older people prescribed antidepressants on the basis of fewer symptoms of depression, and for longer periods of time? A survey of 1825 New Zealanders
Read, J., Gibson, Kerry L and Cartwright, Claire 2016. Are older people prescribed antidepressants on the basis of fewer symptoms of depression, and for longer periods of time? A survey of 1825 New Zealanders. Australasian Journal on Ageing. 35 (3), pp. 193-197. https://doi.org/10.1111/ajag.12314
Are mental health staff getting better at asking about abuse andneglect?
Sampson, M. and Read, J. 2016. Are mental health staff getting better at asking about abuse andneglect? International Journal of Mental Health Nursing. 26 (1), pp. 95-104. https://doi.org/10.1111/inm.12237
The Twin Research Debate in American Criminology
Joseph, Jay, Chaufan, Claudia, Richardson, Ken, Shultziner, Doron, Fosse, Roar, James, Oliver, Latham, Jonathan and Read, J. 2015. The Twin Research Debate in American Criminology. Logos: A Journal of Modern Society & Culture. 15.
Understanding the non-pharmacological correlates of self-reported efficacy of antidepressants
Read, J., Gibson, K., Cartwright, C., Shiels, C., Dowrick, C. and Gabbay, M. 2015. Understanding the non-pharmacological correlates of self-reported efficacy of antidepressants. Acta Psychiatrica Scandinavica. 131 (6), pp. 434-445.