The Lundby cohort consisting of 3563 subjects was investigated in 1947, 1957, 1972, and 1997. It represents a rural, but gradually urbanized Swedish sample without non-Nordic immigrants and offers an opportunity to study suicide rates before and after the introduction of tricyclic antidepressant drugs in Sweden in 1962. Since then, a fall in suicide rate among depressed individuals was observed, while there was an increase in the overall suicide rate. In fact, in 1977-1992 other psychiatric diagnoses, alcohol disorder included, were more often associated with suicide than depression. No psychiatric or alcohol disorder was registered in 7% of the suicides.