In a working paper released recently, economists looked at the efficacy of antidepressants in a novel manner — how do SSRI antidepressant sales correspond to suicide rates? Examining data from 26 countries over the past 25 years, they found that an increase in SSRI sales of 1 pill per capita is associated with a decline in suicide mortality of around 5 percent.

Their discussion pretty much sums up their findings better than I can:

Our estimates suggest that on balance SSRIs may be a very cost-effective means for saving lives, which is important in part because data from the National Comorbidity Survey from 2001-3 suggest that only around 40 percent of people with severe mental health disorders were receiving any treatment [Kessler, Demler et al., 2005]. Commonly used SSRIs can currently be obtained in the United States for around $0.10 per pill. Our estimates thus imply that each additional $20,000 spent on SSRIs will avert one suicide completion, far below the cost per life saved from most other public health, regulatory, or other forms of government intervention.

But using this estimate in a more formal benefit-cost analysis raises difficult conceptual and normative questions about the appropriate way to value the life of someone who subjectively prefers death (at least at the time of the intervention). If SSRIs reduce the risk of suicide by reducing access to a method of self harm, then the suicidal person may or may not experience a switch to SSRIs as a net benefit, depending on the transience or permanence of their state of pain. On the other hand if SSRIs reduce the risk of suicide by improving the subjective utility of life, then persons at risk for suicide and their loved ones may have a considerable willingness to pay for such an intervention. Of course SSRIs also generate other benefits beyond their net effects on mortality that should be counted in this calculus, including improvements in mood, health status, functioning, and productivity.

Of course their study can’t answer questions about clinical efficacy and suicide, but they do provide an interesting public health view of this issue — that, in general, SSRI antidepressants decrease suicide in the population.

Hat Tip: Greg Mankiw’s Blog: Anti-depressants and Suicide
Working Paper: Anti-depressants and Suicide (available in PDF)

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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    Last reviewed: By John M. Grohol, Psy.D. on 22 Feb 2007
    Published on PsychCentral.com. All rights reserved.