Evidence mapPaperPMID 42322659Full record

ArticleInternational journal of geriatric psychiatry2026

Central Nervous System (CNS) Medication Use Before Suicide Among Older Adults in Sweden From 2007 to 2020: A Register-Based Case-Control Study.

Theodore Tianyi Miao, Máté Szilcz, Zheng Chang, Jonas W Wastesson, Kristina Johnell

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Article in International journal of geriatric psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Theodore Tianyi MiaoDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0009-0002-1278-3885
Máté SzilczDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Zheng ChangDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Jonas W WastessonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.ORCID https://orcid.org/0000-0001-7601-4319
Kristina JohnellDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Funding

Swedish Research Council for Health, Working Life and Welfare 2023-00144Swedish Research Council for Health, Working Life and Welfare 2023-00164
6 · The paper itself

Abstract

backgroundOlder adults represent a high-risk group for suicide and are frequently exposed to central nervous system (CNS) drugs. Yet, the role of CNS drugs in late-life suicide remains unclear.

methodsWe conducted a nationwide register-based matched case-control study (1:30) including all individuals aged 65 years and older who died by suicide in Sweden between 2007 and 2020. Each case was matched to controls from the general population on age and sex, alive at the index date. Use of CNS medications was examined within 1-month, 3-month, and 12-month windows prior to the index date (date of suicide). Conditional logistic regression was used to estimate odds ratios (ORs) with adjustment for sociodemographic factors, number of other classes of medications (proxy for comorbidities), frailty score, self-harm history and major psychiatric diagnoses.

resultsAmong 5971 older adults who died by suicide, 71.7% of cases used at least one type of CNS drug (vs. 35.2% of controls), while 34.7% of cases had dispensations for three or more CNS drug types (vs. 7.3% of controls) within one year before death by suicide. The most common drug classes among cases were hypnotics and sedatives (46.5%) and antidepressants (38.8%). About one third of cases used anxiolytics (32.3%) or minor analgesics and antipyretics (29.9%). Compared with controls, individuals who died by suicide more often used hypnotics and sedatives (adjusted OR 3.54, 95% CI 3.32-3.77), anxiolytics (aOR 3.27, 95% CI 3.04-3.52), antidepressants (aOR 2.50, 95% CI 2.33-2.68), and opioids (aOR 1.93, 95% CI 1.79-2.09) within 12 months before suicide. Patterns were consistent across time windows.

conclusionsCNS medications are commonly dispensed before suicide in older adults, particularly hypnotics and sedatives, antidepressants, anxiolytics, and opioids. These findings describe medication use patterns preceding suicide and identify drug classes for further investigation.

Indexed as

Central Nervous System AgentsSuicideAgedAged, 80 and overAntidepressive AgentsCase-Control StudiesFemaleHumansHypnotics and SedativesLogistic ModelsMaleRegistriesSwedenAntidepressive AgentsCentral Nervous System AgentsHypnotics and SedativesCNS medicationsdrug utilizationepidemiologyolder adultspharmacoepidemiologysuicide

Identifiers

PMID42322659
PMCPMC13283041

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.