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The association between melatonin and suicide: a nationwide cohort study

Published online by Cambridge University Press:  01 September 2022

N. Høier ,
T. Madsen ,
A. Spira ,
K. Hawton ,
P. Jennum ,
M. Nordentoft  and
A. Erlangsen
N. Høier*
Affiliation:
Mental Health Centre Copenhagen (CORE), Danish Research Institute For Suicide Prevention, Hellerup, Denmark
T. Madsen
Affiliation:
Mental Health Center Copenhagen, Core-copenhagen Research Center For Mental Health, Hellerup, Denmark
A. Spira
Affiliation:
Johns Hopkins Bloomberg School of Public Health, Department Of Mental Health, Baltimore, United States of America
K. Hawton
Affiliation:
University of Oxford, Centre For Suicide Research, Oxford, United Kingdom
P. Jennum
Affiliation:
Danish Center for Sleep Medicine, Rigshospitalet, Copenhagen University, Copenhagen N, Denmark
M. Nordentoft
Affiliation:
CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Hellerup, Denmark
A. Erlangsen
Affiliation:
CORE-Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Hellerup, Denmark
*
*Corresponding author.

Abstract

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Introduction

Melatonin is often prescribed to patients experiencing sleep disturbances, which has been linked to elevated risks of suicide. However, it remains to be assessed whether melatonin is associated with suicide and suicide attempts.

Objectives

We aimed to investigate whether individuals in treatment with melatonin had higher rates of suicide and suicide attempt when compared to individuals not in treatment.

Methods

Using longitudinal data on all persons aged 10+ years living in Denmark between 2007-2016 were obtained. Data from the National Prescription Register was used to identify periods of being in treatment with melatonin based on number of tablets and daily defined dose. Suicide and suicide attempt were identified in hospital and cause of death registries.

Results

Among 5,798,923 included individuals, 10,577 (0.18%) were in treatment with melatonin (mean treatment length 50 days). Out of 5,952 individuals who died by suicide, 22 (0.37%) were in melatonin treatment, while 134 (0.53%) out of 25,136 had a first suicide attempt. After adjustment for sex and age-group, people in treatment with melatonin were found to have a higher rate of suicide (IRR: 4.2; 95% CI, 2.7-6.4) and suicide attempt (IRR: 6.7-fold (95% CI, 5.7-7.9) when compared to those not in treatment.

Conclusions

Treatment with melatonin was associated with higher rates of suicide and suicide attempt. The association might be explained through mediators, such as psychiatric comorbidity and sleep disorders. Our findings indicate that attention towards these issues might be warranted.

Disclosure

No significant relationships.

Keywords

sleep medicinemelatoninPharmacologySuicide
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S843
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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