Sales of antidepressants, suicides and hospital admissions for depression in Veneto Region, Italy, from 2000 to 2005: an ecological study

Data from the Italian Ministry of Health (admissions for depression), the Pharmacy Service of a Local Health Unit (antidepressant prescribing) and from the Epidemiological System of the Veneto region (suicide rates) were collected from 2000 to 2005 for the Veneto region.Suicide rates did not show any marked increase but were stable in males and females. Antidepressant prescribing increased exponentially over the period examined, whilst admissions for depression markedly decreased. The trend for an exponential increase in antidepressant prescribing in the Veneto region is shared with other countries and locales.It is possible that the increase in antidepressant prescribing might be associated with earlier treatment of depression, thus decreasing the likelihood of aggravation of depression.Antidepressant prescribing has risen in several countries worldwide over the last 20 years, mainly after the introduction of selective serotonin reuptake inhibitors (SSRIs) [1,2]. This increase may be the result of better treatment and recognition of depression [3]. However, some concerns have been raised over the fact that antidepressant use may increase the risk of suicide [4]. Ecological studies have shown some evidence that more widespread antidepressant use corresponds to a decrease in suicide rates [1], although this finding is disputed [5]. Some studies show that treating more depressed patients with antidepressants may prevent suicides [6]. Moreover, a meta-analysis by Barbui and colleagues [7] on observational studies, showed that use of SSRIs is associated with a reduced risk of suicide in adults with depression, particularly in people aged 65 or over.Other than suicide and antidepressant prescribing, the pattern of hospital admissions for depression can be another valid indicator when exploring trends in the prevalence of depression and may shed some light on the relationship between suicide rates and depression. In one of the few ecological studies on the topic, Vyssoki