Access to Psychotropic Medication via Prescription Is Associated With Choice of Psychotropic Medication as Suicide Method

Brown, Talia L.; Gutierrez, Peter M.; Grunwald, Gary K.; DiGuiseppi, Carolyn; Valuck, Robert J.; Anderson, Heather

doi:10.4088/jcp.17m11982

Cited by 11 publications

(8 citation statements)

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“…In addition, while psychotropic drugs have an established efficacy in treating psychiatric disorders, early pharmaco-epidemiological studies have suggested a positive correlation between rates of their prescription and those of their use in non-fatal suicidal behaviour [6, 7]. A recent study showed that subjects using a psychotropic drug during a self-harm act are more likely to have had recent prescribed access to any psychotropic drug and to the drug type used prior to the self-harm episode when compared to those not using any psychotropic drug in a self-harm episode [8]. A better understanding of the link between rates of drug prescriptions and those of self-harm acts can be expected to contribute substantially to the prevention of suicide.…”

Section: Introductionmentioning

confidence: 99%

Medication used in intentional drug overdose in Flanders 2008-2013

et al. 2019

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Background Intentional drug overdose is the most common method of self-harm. As psychiatric disorders are very common in self-harm patients, the medication used to treat these disorders can become the means for the self-harm act. The present study aimed at investigating an association between the use of prescribed medication (analgesics and antipyretics, anti-epileptics, antipsychotics, antidepressants and psychostimulants) as a method of self-harm and prescription rates of this medication in Flanders. We investigated the possible effect of gender, alcohol use during the self-harm act and a history of self-harm. Methods Data from the multicenter study of self-harm in Flanders between 2008 and 2013 were used. The significance of differences in percentages was calculated by GEE and the strength by odds ratios (OR). Results There was an increase in the odds of using antidepressants (0.8%) and antipsychotics (2%) among females when the rate of prescription increases. Analgesics and antipyretics (39.3/1,000) and antidepressants (124.9/1,000) were the most commonly prescribed drugs among females. Antidepressants (63.9/1,000) and antipsychotics (26.5/1,000) were the most commonly prescribed drugs among males. Antidepressants and analgesics and antipyretics were the most frequently used medications for self-harm. Analgesics and antipyretics during the self-harm act were more common among first-timers, while repeaters more commonly overdosed using antipsychotics and antidepressants. Conclusion These findings suggest that the availability of medication via prescriptions plays an important role in the choice of the medication ingested during the self-harm act. Precautions are necessary when prescribing medication, including restrictions on the number of prescriptions and the return of unused medication to pharmacies after cessation of treatment. These issues should be a focus of attention in the education and training of physicians and pharmacists.

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Section: Introductionmentioning

confidence: 99%

Medication used in intentional drug overdose in Flanders 2008-2013

et al. 2019

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“…The selection of a suicide method is generally thought to depend on accessibility, 18,19 and larger medication loads are found in people who have engaged in an intentional overdose. 19 Prescribed psychotropics are easily available as a means of suicide, 20 and furthermore, psychotropics are often prescribed after an intentional overdose episode. 21,22 Despite the abovementioned risks associated with prescribing psychotropic medications, few studies have quantitatively investigated the association between psychotropic prescriptions and the risk of intentional overdose.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between psychotropic prescriptions and the total amount of psychotropics ingested during an intentional overdose: A single‐center retrospective study

Tanahashi

Shiganami

Iwayama

et al. 2022

Neuropsychopharm Rep

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Aim:To investigate the association between psychotropic prescriptions and the total amount of psychotropics ingested during a subsequent intentional overdose and to examine factors related to the number of psychotropic prescriptions. Methods:The initial sample comprised 69 patients who were admitted to the emergency department of a general hospital in Japan following an intentional overdose via psychotropic medications. We performed retrospective hierarchical multiple regression analysis with the total amount of psychotropics ingested at the overdose as a dependent variable and factors related to deliberate self-harm or overdose identified in previous studies as independent variables. We compared two models, one that did not (Step 1) and one that did (Step 2) include the number of different prescribed psychotropic medications as an independent variable in the analysis.Results: Forty-seven patients were eligible for the analysis. The number of different prescribed psychotropic medications was associated with the total amount of psychotropics ingested at the overdose in Step 2 (β = 0.40, P = .01). There was a trend toward an association between the past number of deliberate self-harm events and the total amount of psychotropics ingested at the overdose in Step 1 (β = 0.30, P = .05), but this trend was weakened in Step 2 (β = 0.15, P = .33). Conclusion:The number of different prescribed psychotropics appeared to influence the risk of subsequent intentional overdose through increasing the total amount of psychotropics ingested. Cumulative psychotropic prescriptions, particularly those delivered after deliberate self-harm, might be indirectly related to this risk.

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“…BZs have been reported to be the most common psychotropic drugs with a tendency for overdose [8] and are associated with an increased risk of suicide [9][10][11]. Furthermore, it has been reported that as with abuse of illegal drugs, such as stimulants, the use of BZs is associated with certain patient characteristics, including younger age and female sex [12].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of factors related to overdose in patients with impaired consciousness who are transported by emergency medical services: an age-specific research

Nagashima

Sumida

Imanaka

et al. 2021

J Pharm Health Care Sci

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Background Drug overdose accounts for most of the admissions to the emergency department. Prescription drugs, most of which are psychotropic medications, are often misused for drug overdose. The purpose of this study was to investigate the association between overdose in patients transported with disorders of consciousness and psychotropic medications administered prior to transport, so as to enable quick differentiation of drug overdose patients from patients with disorders of consciousness. Methods We evaluated 222 patients transported to the Advanced Critical Care Center of Teikyo University Hospital due to disorders of consciousness. The patients were categorized into two groups: overdose group (n = 128) and control group with other disorders of consciousness (n = 94). Logistic regression models were used to assess the association between disorders of consciousness due to drug overdose and psychotropic drugs prescribed before emergency transportation based on sex and age. Results According to multivariate logistic regression analysis, only female sex (odds ratio [OR] 4.54, 95% confidence interval [CI] 2.43–8.05, P < 0.0001) was associated with overall overdose. Results from the univariate logistic regression analysis showed that in the group of patients aged 40–50 years, female sex (OR 4.36, 95% CI; 1.54–12.4, P = 0.006) and the use of psychotropic drugs (OR 5.05, 95% CI; 1.75–14.6, P = 0.003), benzodiazepines (OR 4.64, 95% CI; 1.61–13.4, P < 0.05), antidepressants (OR 11.4, 95% CI; 2.35–55.8, P = 0.003), and anticonvulsants (OR 4.46, 95% CI; 1.11–17.9, P = 0.035) were associated with overdose. According to multivariate logistic regression analysis, female sex (OR 4.44, 95% CI; 1.37–14.3, P = 0.013) and antidepressants (OR 7.95, 95% CI; 1.21–52.1, P = 0.031) were associated with overdose patients aged 40–50 years. Conclusions As a reference in distinguishing overdose in women in their 40s and 50s who present with impaired consciousness, attention may need to be paid to the type of psychotropic drug used, especially antidepressants.

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Access to Psychotropic Medication via Prescription Is Associated With Choice of Psychotropic Medication as Suicide Method

Cited by 11 publications

References 0 publications

Medication used in intentional drug overdose in Flanders 2008-2013

Medication used in intentional drug overdose in Flanders 2008-2013

Association between psychotropic prescriptions and the total amount of psychotropics ingested during an intentional overdose: A single‐center retrospective study

Evaluation of factors related to overdose in patients with impaired consciousness who are transported by emergency medical services: an age-specific research

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