Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-29T02:13:44.153Z Has data issue: false hasContentIssue false
  • English
  • Français

How safe are psychiatric medications after a voluntary overdose?

Published online by Cambridge University Press:  16 April 2020

Enrique Baca-García ,
Carmen Diaz-Sastre ,
Jeronimo Saiz-Ruiz  and
Jose de Leon
Enrique Baca-García
Affiliation:
Department of Psychiatry, Hospital Ramon y Cajal, University of Alcala, Madrid, Spain
Carmen Diaz-Sastre
Affiliation:
Department of Psychiatry, Hospital Ramon y Cajal, University of Alcala, Madrid, Spain
Jeronimo Saiz-Ruiz
Affiliation:
Department of Psychiatry, Hospital Ramon y Cajal, University of Alcala, Madrid, Spain
Jose de Leon*
Affiliation:
Mental Health Research Center at Eastern State Hospital, 627 West Fourth Street, Lexington, KY 40508, USA
*
*Corresponding author. E-mail address: jdeleon@uky.edu (J. de Leon).
Get access

Summary

Purpose.

This study assessed psychiatric medications and their potential lethality in a representative sample of suicide attempts.

Materials and methods.

During 1996–98, 563 suicide attempts were studied in a general hospital in Madrid (Spain). Medication overdose was used in 456 suicide attempts (81%). The ratio between dose taken and maximum prescription dose recommended was used to evaluate the medication toxicity.

Results.

Benzodiazepines were the drugs most often used in self-poisoning (65% of overdoses), followed by new antidepressants (11%), tricyclic antidepressants (TCAs) (10%), and antipsychotics (8%). An overdose with any of the three latter psychiatric medications was significantly more frequent in patients prescribed those medications. The overdoses for TCA were potentially lethal in 47% of the cases. However, all patients who overdosed on psychiatric medications recovered well and were discharged without any sequelae.

Discussion.

This study suggests that psychiatric medications, particularly benzodiazepines, new antidepressants and antipsychotics, are relatively safe when they are used for self-poisoning. If patients with mental illnesses are under treated, there is a clear and documented higher risk for suicide.

Conclusion.

It is better to prescribe psychiatric medications, particularly the new ones, rather than withhold them due to an exaggerated fear of a lethal overdose

Keywords

SuicideSuicide attemptsSelf-poisoningPsychiatric drugsOverdoseMortality
Type
Original Article
Information
European Psychiatry , Volume 17 , Issue 8 , December 2002 , pp. 466 - 470
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Jamisson, K.Night falls fast-understanding suicide New York: Alfred A. Knopf; 1999.Google Scholar
NIMH. Suicide Facts December 1999 http://www.nimh.nih.gov/research/suifact.htm.Google Scholar
CDC. Suicide in the United States May 2000 http://www.cdc.gov4:2530./ncipc/factsheets/suifacts.htm.Google Scholar
Crosby, A.E., Cheltenham, M.P., Sacks, J.J.Incidence of suicidal ideation and behavior in the United States Suicide Life Threat Behav 1999; 29: 131-140.Google Scholar
Kessler, R.C., Borges, G., Walters, E.E.Prevalence of and risk factors for lifetime suicide attempts in the national comorbidity survey Arch Gen Psychiatry 1999; 56: 617-626.Google Scholar
Dhossche, D.M.Suicidal behavior in psychiatric emergency room patients South Med J 2000; 93: 310-314.Google Scholar
Harris, C., Barraclough, B.Suicide as an outcome for mental disorders Br J Psychiatry 1997; 170: 205-228.CrossRefGoogle Scholar
Mann, J.J.The neurobiology of suicide Nat Med 1998; 4: 25-30.Google Scholar
Stone, G.Suicide and attempted suicide New York: Carroll & Graff Publications; 1999.Google Scholar
Buckley, N.A., Whyte, I.M., Dawson, A.H.et al. Correlations between prescriptions and drugs taken in self poisoning: implications for prescribers and drug regulation Med J Aust 1995; 62: 194-197.Google Scholar
Cooper, J.Toxicity, sedative-hypnotics. http://emedicine.com/cgibin/foxweb.exe/showsection@d:/em/ga?book = emerg&topicid = 52.Google Scholar
Drug & Therapy Perspectives. Antidepressants: one of many drug classes used in suicide attempts Drugs Ther Perspect 1997; 10: 14-16.Google Scholar
Drug & Therapy Perspectives. Recognition and treatment of serious antipsychotic drug overdose Drugs Ther Perspect 1998; 11: 13-16.Google Scholar
Mason, J., Freemantle, N., Eccles, M.Fatal toxicity associated with antidepressant use in primary care Br J Gen Pract 2000; 50: 366-370.Google Scholar
Isacsson, G., Holmgren, P., Druid, H., Bergman, U.The utilization of antidepressants – a key issue in the prevention of suicide: an analysis of 5281 suicides in Sweden during the period 1992–1994 Acta Psychiatr Scand 1997; 96: 94-100.Google Scholar
Shah, R., Uren, Z., Baker, A., Majeed, A.Deaths from antidepressants in England and Wales 1993–1997: analysis of a new national database Psychol Med 2001; 31: 1203-1210.Google Scholar
Schreinzer, D., Frey, R., Stimpfl, T., Vycudilik, W., Berzlanovich, A., Kasper, S.Different fatal toxicity of neuroleptic identified by autopsy Eur Neuropsychopharmacol 2001; 11: 117-124.Google Scholar
Capel, M.M., Colbridge, M.G., Henry, J.A.Overdose profiles of new antipsychotics Int J Neuropsychopharmacol 2000; 3: 51-54.CrossRefGoogle Scholar
Isacsson, G., Holmgren, P., Druid, H., Bergman, U.Psychotropics and suicide prevention. Implications from toxicological screening of 5281 suicides in Sweden 1992–1994 Br J Psychiatr 1999; 174: 259-265.Google Scholar
McMahon, G.T., McGarry, K.Deliberate self-poisoning in an Irish county hospital Ir J Med Sci 2001; 170: 94-97.Google Scholar
Kelly, C.B., Weir, J., Rafferty, T., Galloway, R.Deliberate self-poisoning presenting at a rural hospital in Northern Ireland 1976–1996: relationship to prescribing Eur Psychiatr 2000; 15: 348-353.Google Scholar
O’Carroll, P.W., Berman, A.L., Maris, R.W., Moscicki, E.K., Tanney, B.L., Silverman, M.Beyond the tower of Babel: a nomenclature for suicidology Suicide Life Threat Behav 1996; 26: 237-245.Google Scholar
Ryan, K.O., Graf, S.E., Paloucek, F.P.Selective prescribing in suicidal patients: a little thought can decrease the risk of future morbidity and mortality Ann Pharmacother 1997; 31: 924-925.Google Scholar
Lejoyeux, M., Rouillon, F.Suicide and psychotropic drugs Encephale 1996; 22 Spec:40–45 〚in French〛.Google Scholar
Submit a response

Comments

No Comments have been published for this article.