How can an inverse correlation between these variables and the suicide rate in some countries be interpreted, when a positive correlation was expected? Considering alcohol consumption, even though patterns of alcohol use differ from culture to culture, it is known that alcohol abuse can contribute to an increased risk of suicidal behavior. Therefore, it would be expected that a reduction in suicide would be accompanied by a reduction in alcohol intake. Notwithstanding, in Hungary, between 1990 and 1998 alcohol sales increased by 25% and suicide rates dropped by 20% and in a Hungarian suicide prevention project, the intervention region had a higher alcohol-related death rate both before and after the program compared with the control region. Moreover, there was a decrease in alcohol-related deaths over time in both regions, and the expected improvement in the intervention region was not confirmed. Also, in a previous study performed in 1980�C1982 in Portugal, the inverse association between suicide rates and alcohol Tubeimoside-I cirrhosis deaths had a distinctive regional distribution: whereas in the north, alcohol uptake and cirrhosis death was greater than in the south, suicide rates were much greater in the south, suggesting that alcohol addiction is on many occasions either a depression equivalent or a self-medication strategy. Overall, cultural differences are also important in explaining variation in the associations across countries. There are a number of limitations to this analysis. Utilisation is only a proxy for rates of what occurs at the individual patient level: we do not know if people take the medication they obtain, or if they are taking less or more than the standard DDD. The real rates of treatment of depression in Europe could conceivably be lower than the high DDD/1000/day would suggest, taking in account the multiple indications of antidepressants, frequent use of higher dosages than the DDD, non-compliance, and co-therapy with a second antidepressant. Nor do we know the proportion of individuals taking these medications that complete suicide. In addition, we do not know the gender and age distribution of antidepressant use, and so have not attempted to look at the impacts of antidepressants on suicide rates by age or gender. We also do not know the distribution of utilisation in relation to severity of depression and anxiety disorders although some surveys in Europe suggest the gap is greater in the lower end of severity, and a recent meta-analysis suggests the value of antidepressants for light and moderate as well as severe depression. It should also be acknowledged that antidepressants are prescribed for other mental health problems in addition to depression, as well as for physical health problems. We also know that poor physical health can be a risk factor for suicide. Our analysis is also limited by Gentamycin Sulfate focusing only on completed suicides, but a proportion of undetermined deaths will also be due to suicide; potentially including these data in our analysis might impact on findings, particularly in countries such as Portugal and Eastern Europe countries where undetermined deaths are considerable. Future analysis should consider ‘probable suicide’i.e. the sum of registered suicides and undetermined violent deaths. Another limitation of our analysis is a lack of data on the use of psychological therapies, alongside or as an alternative to the use of antidepressants in treating depression and related disorders, 
and therefore potentially contributing to the prevention of suicides. Many of these limitations can only addressed through improvements in epidemiological datasets;