Working Paper: NBER ID: w12906
Authors: Jens Ludwig; Dave E. Marcotte; Karen Norberg
Abstract: Does drug treatment for depression with selective serotonin reuptake inhibitors (SSRIs) increase or decrease the risk of completed suicide? The question is important in part because of recent government warnings that question the safety of SSRIs, one of the most widely prescribed medications in the world. While there are plausible clinical and behavioral arguments that SSRIs could have either positive or negative effects on suicide, randomized clinical trials have not been very informative because of small samples and other problems. In this paper we use data from 26 countries for up to 25 years to estimate the effect of SSRI sales on suicide mortality using just the variation in SSRI sales that can be explained by cross-country variation in the growth of drug sales more generally. We find that an increase in SSRI sales of 1 pill per capita (about a 12 percent increase over 2000 sales levels) is associated with a decline in suicide mortality of around 5 percent. These estimates imply a cost per statistical life far below most other government interventions to improve health outcomes.
Keywords: SSRIs; suicide; mental health; public policy
JEL Codes: I12; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| SSRI sales (I11) | suicide mortality (I12) |
| increase in SSRI sales of 1 pill per capita (D12) | reduction in suicide mortality (J17) |
| SSRIs sold (I11) | averted suicide (I12) |
| SSRI sales (I11) | costs per statistical life saved (J17) |