This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Carlsten, A. Articles by Allebeck, P. Search for Related Content PubMed PubMed Citation Articles by Carlsten, A. Articles by Allebeck, P. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Suicide Social Bookmarking                         What's this?

The role of benzodiazepines in elderly suicides

Department of Social Medicine, University of Göteborg, Sweden, Anders.Carlsten{at}apoteket.se, National Corporation of Pharmacies, Apoteket AB, Sweden

Margda Waern

Section of Psychiatry, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg, Sweden

Per Holmgren

Department of Forensic Chemistry, National Board of Forensic Medicine, Linköping, Sweden

Peter Allebeck

Department of Social Medicine, University of Göteborg, Sweden

Aims: In Sweden, suicides by drug poisoning have decreased in the population at large during the past two decades. However, drug poisoning suicides increased among the elderly during this period. Suicides by benzodiazepine poisoning increased in this age group despite a reduction in prescription sales of these drugs. This study aims therefore to determine the role of benzodiazepines in suicide late in life. Methods: Information concerning all definite suicides and deaths due to ``undetermined'' causes recorded among Swedish citizens aged 65 and above during 1992 - 96 was obtained from the Cause-of-Death Register. Death certificates were scrutinized to determine the type of drug employed in drug-related suicides. Results of the post mortem screening for drugs and alcohol were then examined. Results: A benzodiazepine was implicated in 216/548 (39%) of the drug poisoning suicides recorded among the elderly. Death certificates revealed that a benzodiazepine was the sole agent in 72% of these cases. Flunitrazepam or nitrazepam were implicated in 90% of the single benzodiazepine suicides. In addition to the suicides classified as drug poisonings, 82 cases were found in which a drug may have contributed to the cause of death. Benzodiazepines predominated. The terminal cause of death was drowning, often in the victim's own bathtub, in three-quarters of these cases. The annual fatality ratios for the newer benzodiazepine-like hypnotics zopiclone and zolpidem appear to be on the rise. Conclusion: Benzodiazepines, especially the hypnotics flunitrazepam and nitrazepam, are common in drug poisoning suicides in the elderly and should be prescribed with caution for this age group.

Key Words: benzodiazepine • drug poisoning • elderly • suicide.

Scandinavian Journal of Public Health, Vol. 31, No. 3, 224-228 (2003)
DOI: 10.1080/14034940210167966


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?