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Anti-depressants and suicide

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  • Ludwig, Jens
  • Marcotte, Dave E.
  • Norberg, Karen

Abstract

Suicide takes the lives of around a million people each year, most of whom suffer from depression. In recent years there has been growing controversy about whether one of the best-selling anti-depressants - selective serotonin reuptake inhibitors (SSRIs) - increases or decreases the risk of completed suicide. Randomized clinical trials are not informative in this application because of small samples and other problems. We present what we believe are the most scientifically credible estimates to date on how SSRI sales affect suicide mortality using data from 26 countries for up to 25 years. We exploit just the variation in SSRI sales that can be explained by institutional differences in how drugs are regulated, priced, and distributed, as reflected by the sales growth of new drugs more generally. We find an increase in SSRI sales of 1 pill per capita (12% of 2000 sales levels) reduces suicide by 5%.

Suggested Citation

  • Ludwig, Jens & Marcotte, Dave E. & Norberg, Karen, 2009. "Anti-depressants and suicide," Journal of Health Economics, Elsevier, vol. 28(3), pages 659-676, May.
  • Handle: RePEc:eee:jhecon:v:28:y:2009:i:3:p:659-676
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    Cited by:

    1. Janet M. Currie & W. Bentley MacLeod, 2020. "Understanding Doctor Decision Making: The Case of Depression Treatment," Econometrica, Econometric Society, vol. 88(3), pages 847-878, May.
    2. Charlotte Björkenstam & Jette Möller & Gunilla Ringbäck & Peter Salmi & Johan Hallqvist & Rickard Ljung, 2013. "An Association between Initiation of Selective Serotonin Reuptake Inhibitors and Suicide - A Nationwide Register-Based Case-Crossover Study," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.
    3. Nadia Campaniello & Theodoros M. Diasakos & Giovanni Mastrobuoni, 2017. "Rationalizable Suicides: Evidence from Changes in Inmates’ Expected Length of Sentence," Journal of the European Economic Association, European Economic Association, vol. 15(2), pages 388-428.
    4. W. Bentley MacLeod, 2017. "Viewpoint: The human capital approach to inference," Canadian Journal of Economics, Canadian Economics Association, vol. 50(1), pages 5-39, February.
    5. Katolik, Aleksandra & Oswald, Andrew J., 2017. "Antidepressants for Economists and Business-School Researchers: An Introduction and Review," Die Unternehmung - Swiss Journal of Business Research and Practice, Nomos Verlagsgesellschaft mbH & Co. KG, vol. 71(4), pages 448-463.
    6. Janet M. Currie & W. Bentley MacLeod, 2018. "Understanding Doctor Decision Making: The Case of Depression," NBER Working Papers 24955, National Bureau of Economic Research, Inc.
    7. Strulik, Holger, 2019. "An economic theory of depression and its impact on health behavior and longevity," Journal of Economic Behavior & Organization, Elsevier, vol. 158(C), pages 269-287.
    8. Bütikofer, Aline & Cronin, Christopher J. & Skira, Meghan M., 2020. "Employment effects of healthcare policy: Evidence from the 2007 FDA black box warning on antidepressants," Journal of Health Economics, Elsevier, vol. 73(C).
    9. Mateus Dias & Luiz Felipe Fontes, 2020. "The Effects of a Large-Scale Mental Health Reform: Evidence from Brazil," Working Papers 09, Instituto de Estudos para Políticas de Saúde.
    10. Lien, Donald & Zhang, Shuo, 2020. "Words matter life: The effect of language on suicide behavior," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 86(C).
    11. Dubois, Pierre & Tuncel, Tuba, 2020. "Identifying the Effects of Scientific Information and Recommendations on Physicians’ Prescribing Behavior," TSE Working Papers 20-1114, Toulouse School of Economics (TSE).
    12. Blanchflower, David G; Oswald, Andrew, 2011. "Antidepressants and Age," CAGE Online Working Paper Series 44, Competitive Advantage in the Global Economy (CAGE).
    13. Masiero, Giuliano & Mazzonna, Fabrizio & Steinbach, Sandro, 2020. "Happy Pills? Mental Health Effects of the Dramatic Increase of Antidepressant Use," IZA Discussion Papers 13727, Institute of Labor Economics (IZA).
    14. Blanchflower, David G. & Oswald, Andrew J., 2016. "Antidepressants and age: A new form of evidence for U-shaped well-being through life," Journal of Economic Behavior & Organization, Elsevier, vol. 127(C), pages 46-58.
    15. Cornelius Christian & Lukas Hensel & Christopher Roth, 2019. "Income Shocks and Suicides: Causal Evidence From Indonesia," The Review of Economics and Statistics, MIT Press, vol. 101(5), pages 905-920, December.
    16. Giuliano Masiero & Fabrizio Mazzonna & Sandro Steinbach & Olaf Verbeek, 2019. "The effect of local growth in antidepressant consumption on mental health outcomes," IdEP Economic Papers 1902, USI Università della Svizzera italiana.
    17. Nadia Campaniello & Theodoros Diasakos & Giovanni Mastrobuoni, 2012. "Rational Suicides: Evidence from Changes in Inmates' Expected Sentence Length," Carlo Alberto Notebooks 247, Collegio Carlo Alberto.
    18. Pecchenino, Rowena A., 2015. "Have we cause for despair?," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 58(C), pages 56-62.
    19. Dias, Mateus & Fontes, Luiz Felipe, 2020. "The Effects of a Large-Scale Mental-Health Reform: Evidence from Brazil," MPRA Paper 104753, University Library of Munich, Germany.

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    More about this item

    Keywords

    Suicide Drug regulation Anti-depressant treatment;

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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