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Keywords:

  • angiotensin enzyme inhibitors;
  • β-adrenoceptor blockers;
  • calcium channel blockers;
  • depression;
  • epidemiology;
  • suicide

Aims  To examine the risk of suicide in users of β-adrenoceptor blockers, calcium channel blockers, and angiotensin converting enzyme inhibitors.

Methods  We conducted a cohort study based on linkage of a population-based prescription registry in North Jutland County, Denmark, and the nationwide Death Registry. From 1989 to 1995 there were 58 529 users of β-adrenoceptor blockers, calcium channel blockers, and angiotensin converting enzyme inhibitors. The mortality rates from suicides in the cohort members were compared with the rates in the general population.

Results One hundred and four suicides occurred in the cohorts. The standardized mortality ratio for suicide in users of β-adrenoceptor blockers was 1.6 (95% confidence interval: 1.2–2.1), in users of calcium channel blockers 1.2 (95% confidence interval: 0.8–1.7), and in users of angiotensin converting enzyme inhibitors 1.2 (95% confidence interval: 0.7–1.8). In users of β-adrenoceptor blockers, the risk of suicide was increased during the first 12 months after the start of therapy, standardized mortality ratio 2.1 (95% confidence interval: 1.2–3.5). There was a trend in the standardized mortality ratio of suicide from 0.9 (95% confidence interval: 0.4–1.9) in users of β-adrenoceptor blockers with low lipid solubility, to 1.6 (0.8–2.8) and 2.7 (1.7–4.1) in users of β-adrenoceptor blockers with medium and high lipid solubility, respectively.

Conclusions Users of medium and high lipid soluble β-adrenoceptor blockers may have an increased risk of suicide. Users of calcium channel blockers and angiotensin converting enzyme inhibitors do not seem to have a significantly increased risk of suicide.