Antidepressant-related deaths and antidepressant prescriptions in England and Wales, 1998–2000

Cheeta, Survjit; Schifano, Fabrizio; Oyefeso, Adenekan; Webb, Lucy; Ghodse, A. Hamid

doi:10.1192/bjp.184.1.41

Cited by 269 publications

(64 citation statements)

References 24 publications

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“…Both indices were significantly greater than that for citalopram, which in turn had a significantly higher mortality index than sertraline. Prior reports, based on comparisons with prescriptions written, have suggested there is greater mortality associated with venlafaxine overdose than with SSRIs (35)(36)(37). Alternatively, Rubino and colleagues (38) found that venlafaxine was more likely to be used in patients who exhibited factors suggesting greater suicidal risk and that adjusting for those factors reduced mortality risk.…”

Section: Discussionmentioning

confidence: 99%

Morbidity and Mortality Associated With Medications Used in the Treatment of Depression: An Analysis of Cases Reported to U.S. Poison Control Centers, 2000–2014

Nelson

Spyker

2017

AJP

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Objective: The authors sought to determine the relative morbidity and mortality associated with drugs used to treat depression and to examine specific clinical effects associated with serious outcomes.Method: The National Poison Data System, which receives exposure reports from regional poison centers serving the United States, Puerto Rico, and the District of Columbia, was queried for single drug exposures in individuals 12 years and older during the period 2000-2014. Medications included were antidepressants, atypical antipsychotics, anticonvulsants, lithium, and other medications used in the treatment of depression. The main outcomes were the morbidity index (the number of serious outcomes per 1,000 exposures) and the mortality index (the number of fatal outcomes per 10,000 exposures).Results: During this 15-year period, there were 962,222 single substance exposures to the 48 medications studied. Serious outcomes rose 2.26-fold and in linear fashion over the 15 years. While tricyclic and monoamine oxidase inhibitor medications were associated with high morbidity and mortality, several newer agents also appeared hazardous. Lithium, quetiapine, olanzapine, bupropion, and carbamazepine were associated with high morbidity indices. Lithium, venlafaxine, bupropion, quetiapine, olanzapine, ziprasidone, valproic acid, carbamazepine, and citalopram were associated with higher mortality indices.Conclusions: Serious outcomes after overdose or nonintentional exposures to medications used to treat depression have risen dramatically over the past 15 years. The present data suggest that the morbidity and mortality risks vary substantially among these medications. These differences become important when selecting treatments for patients with depression, especially those at increased risk for suicide.

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Section: Discussionmentioning

confidence: 99%

Morbidity and Mortality Associated With Medications Used in the Treatment of Depression: An Analysis of Cases Reported to U.S. Poison Control Centers, 2000–2014

Nelson

Spyker

2017

AJP

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“…Increasing fatal poisonings due to drugs has been documented in many studies (40)(41)(42)(43)(44)(45). The distribution of drugs causing fatal poisonings varies depending on the region.…”

Section: Discussionmentioning

confidence: 99%

Fatal Poisonings in the South Marmara Region of Turkey

Fedakar

Türkmen

2008

ELECTRON J GEN MED

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Aim:The aim of this study is to describe the characteristics of medico-legal autopsies of fatal poisonings in the south Marmara region, Turkey, in the period of 1996-2003, in order to provide further data for the characterisation of fatal poisonings, because there is a scarcity of such information from Turkey.Methods: Of the 4242 autopsied cases, 415 (9.8%) deaths due to poisonings were examined; 26.8% females and 73.2% males. The mean age was 40.1±19.2 years old (range 0-88).Results: The three most common types of poison were carbon monoxide (43.5%), insecticides (24.6%), and alcohol (18.4%). The most frequent unnatural manner of death was accidents (67.5%), followed by suicidal (27.5%) deaths. Insecticides were the cause in 71.9% of suicidal poisonings, whereas the cause was carbon monoxide in 63.2%, and alcohol in %27.1% of the unintentional poisonings. The deaths due to carbon monoxide were associated with coal stoves (48.3%), water heaters in bath (31.1%), and fires (17.8%). Organophosphorus insecticides were responsible for 91.1% of total insecticide poisonings. 73.7% of the alcohol poisonings were observed in years [2000][2001][2002], and of the methyl alcohol poisoning, 35.9% and 29.7% were seen in years 2001 and 2002, respectively. Therapeutic drugs were encountered most frequently (75%).Conclusion: In conclusion, in fatal poisoning cases who have undergone medico-legal autopsy in Bursa and province, CO is of great ratio.

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“…More recently, a number of large epidemiological reviews in the UK and Finland have suggested that venlafaxine is associated with more deaths per written prescriptions than other SSRIs suggesting a greater inherent toxicity [3][4][5][6]. It is difficult to determine from these large studies whether this is a true toxic effect or one related to the possibility that venlafaxine is prescribed to patients at higher suicidal risk than those prescribed SSRIs [7].…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Venlafaxine and SSRIs in Deliberate Self-poisoning

2010

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To compare the clinical features of deliberate selfpoisoning with venlafaxine and selective serotonin reuptake inhibitors (SSRIs) presenting to the emergency department of an Australian tertiary referral hospital. A retrospective cohort study comparing all 36 patients who presented with venlafaxine self-poisoning with 44 randomly selected patients with SSRI self-poisoning between 1997 and 2006. Patients who had overdosed on venlafaxine were older (mean age 37.4 versus 28.8 years, p≤0.001) and generally exhibited a higher degree of suicidal intent (p≤0.017). Median venlafaxine dose taken was 35 defined daily doses (DDDs) compared with SSRIs 19.4 DDDs. Those who ingested venlafaxine were more likely to become confused (25% versus 0%; p=0) and have mydriasis (19.4% versus 2%; p≤0.02), than those who took SSRIs. One patient from the venlafaxine group died. Compared with SSRI self-poisoners, patients who deliberately ingested venlafaxine were more likely to exhibit serious suicide intent. They were also more likely to be older, take a higher DDD of the drug, and have confusion and mydriasis. This has implications for management of severely depressed and suicidal patients.

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Antidepressant-related deaths and antidepressant prescriptions in England and Wales, 1998–2000

Abstract: The efficacy and safety of augmentation therapy with TCAs in SSRI-resistant patients should be monitored carefully, and patients prescribed antidepressants should be screened for drug use/misuse.

Cited by 269 publications

References 24 publications

Morbidity and Mortality Associated With Medications Used in the Treatment of Depression: An Analysis of Cases Reported to U.S. Poison Control Centers, 2000–2014

Morbidity and Mortality Associated With Medications Used in the Treatment of Depression: An Analysis of Cases Reported to U.S. Poison Control Centers, 2000–2014

Fatal Poisonings in the South Marmara Region of Turkey

A Comparison of Venlafaxine and SSRIs in Deliberate Self-poisoning

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