(B-158) Central Nervous System (CNS) medication use patterns before suicide among older adults

Background: CNS medication is a common treatment for mental health problems among older adults. Old age is also a risk factor for suicide, particularly among men. The efficacy and safety of different types of CNS medications have been studied extensively, but less so in the older population. Exploring patterns of medication use before suicide may help identify high-risk populations and provide useful knowledge for policy makers and clinicians.

Objectives: To investigate medication use patterns before suicide among Swedish older adults, focusing on CNS medications.

Methods: We used Swedish register data from the Total Population Register, the National Patient Register, and the Swedish Prescribed Drug Register (2005–2023).
We analyzed medication use within 30 days, 90 days, and 12 months before suicide among people aged 65 years and older. Medication duration was calculated by dividing the total prescribed amount by the defined daily dose (DDD).
We studied the prevalence of CNS medication use (i.e. antipsychotics, anxiolytics, hypnotics and sedatives, antidepressants, opioids, other analgesics and antipyretics ) and identified the most commonly prescribed CNS drug classes among older adults who died by suicide. Individuals were classified as users if they had at least one recorded dispensation.

Results: Overall, 5,478 older adults died by suicide during the observation period, with a median age of 75 years. Men accounted for 72% of these deaths. A total of 78.9% were prescribed at least one CNS medication in the 30 days before suicide, 80.3% in the 12 months before suicide, and 83.5% in the twelve months before suicide. The most commonly prescribed classes of CNS medications were hypnotics and sedatives and antidepressants.

Conclusions: Our preliminary findings suggest a high rate of CNS medication use among older adults who died by suicide. Understanding the patterns of different drug classes prior to suicide is crucial for identifying potential risk factors and for informing targeted prevention strategies.