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Psychotropics and suicide prevention

Implications from toxicological screening of 5281 suicides in Sweden 1992–1994

Published online by Cambridge University Press:  02 January 2018

Göran Isacsson
Department of Clinical Neuroscience and Family Medicine, Division of Psychiatry, Karolinska Institute, Huddinge University Hospital, Huddinge, Sweden
Per Holmgren
Department of Forensic Chemistry, National Board of Forensic Medicine, Linköping, Sweden
Henrik Druid
Division of Forensic Medicine, Faculty of Health Sciences, University of Linköping, Sweden
Ulf Bergman
Department of Medical Laboratory Sciences and Technology, Division of Clinical Pharmacology, and WHO Collaborating Centre on Drug Utilization Research and Clinical Pharmacological Services, Karolinska Institute, Huddinge University Hospital, Huddinge, Sweden
E-mail address:



Systematic clinical investigations of consecutive suicides have found psychiatric disorders in 90–95% of subjects (depressive disorder 30–87%).


To investigate use of psychotropics in men and women of different ages who commit suicide.


Results of toxicological screening in 5281 suicides in Sweden 1992–94 were studied.


Psychotropics were detected in 45.3% of the suicides. Antidepressants were detected in 12.4% of the men and 26.2% of the women (7.2% and 14.2%, respectively, of those under 30 years of age). Neuroleptics or antiepileptics (in the absence of antidepressants) were detected in 8.3%, and anxiolytics/hypnotics alone in 20.5% of the subjects. Overdose by an antidepressant was the probable cause of death in 2.1% of the men and 7.9% of the women.


The pattern of psychotropics detected in toxicology was incongruent with the pattern of diagnoses found in the clinical investigations of suicides mentioned above. Depression appears to be undertreated in individuals committing suicide, especially in men and in subjects under 30 years of age.

Copyright © 1999 The Royal College of Psychiatrists 

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Declaration of interest

Financial support provided by the Karolinska Institute, the Swedish Society of Medicine, the Söderström–König Foundation and the Bror Gadelius Memorial Foundation.


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