Trends in antidepressant overdoses

McKenzie, Mary S.; McFarland, Bentson H.

doi:10.1002/pds.1355

Cited by 46 publications

(30 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…million prescriptions were about 10 times higher for TCAs than for SSRIs (Morgan et al, 2004). A similar picture has emerged in the US, where it is has been estimated that if the marked increase in antidepressant overdoses 1983-2003 had involved TCAs rather than SSRIs, then there would have been some 300 excess deaths annually (McKenzie and McFarland, 2007).…”

Section: Tricyclic Antidepressantsmentioning

confidence: 87%

Fatal toxicity of drugs used in psychiatry

Flanagan

2007

Hum. Psychopharmacol. Clin. Exp.

View full text Add to dashboard Cite

Certified deaths from fatal poisoning (accidents, suicides and open verdicts) in England and Wales have declined steadily (from 3952 in 1979 to 2565 in 2004). There was also a small annual reduction in suicides in males and in females over this period. In 2004, self-poisoning accounted for 25% of suicides and open verdicts in males (n ¼ 862) and 45% in females (n ¼ 540).Poisoning death rates per million prescriptions were about 10 times higher for tricyclic antidepressants (TCAs) than for selective serotonin reuptake inhibitors (SSRIs), England and Wales, 1993-2004. However, despite the increased prescription of SSRIs and related compounds in recent years, there has been only a slight decrease (some 10%) in the annual number of antidepressant-related poisoning deaths, in line with the reduction in suicides (all methods) over this period. Citalopram appears to have higher overdose toxicity than other SSRIs. Of newer non-SSRI antidepressants, the overdose toxicity of venlafaxine, although lower than that of TCAs, appears to be higher than that of SSRIs, with seizures, serotonin syndrome, rhabdomyolysis, renal failure and hepatic failure having been reported.Poisoning deaths involving antipsychotics either alone, or with other drugs and/or alcohol are many fewer than those involving antidepressants (713 and 5602 deaths, respectively, England and Wales, 1993-2004). Following the restriction on thioridazine usage (2000), thioridazine-associated fatal poisoning fell to zero by 2002, but this was balanced by an increase in deaths associated with atypical antipsychotics, most notably clozapine, olanzapine and quetiapine. Antipsychotic-related poisoning deaths were higher in 2004 than at any time since 1993.

show abstract

Section: Tricyclic Antidepressantsmentioning

confidence: 87%

Fatal toxicity of drugs used in psychiatry

Flanagan

2007

Hum. Psychopharmacol. Clin. Exp.

View full text Add to dashboard Cite

show abstract

“…39 Although there is insufficient evidence to support a particular therapy in CA overdose, the use of sodium bicarbonate to alkalinize blood to a pH of 7.45 to 7.55 is still considered the primary therapy to prevent and treat cardiac arrhythmias associated with CAs. 40 Proposed criteria for initiating sodium bicarbonate have been variable (Table 4), but in general we recommend blood alkalinization with QRS Ͼ 120 ms. Hypertonic saline solution may be a therapeutic option in refractory cases based on animal studies and limited clinical experience.…”

Section: Antidepressantsmentioning

confidence: 99%

Toxicology in the Critical Care Unit

Alapat

Zimmerman

2008

Chest

View full text Add to dashboard Cite

show abstract

“…This is unlikely due to suicide attempts after initiating antidepressants, which has primarily been a concern for children and adolescents, 14 or to poisoning by these drugs, as it is relatively rare. 15 Several studies have reported no benefit for short-term antidepressant therapy in the treatment of depression, but less is known about the effects on pain. 16,17 Short-term antidepressant therapy may be an indicator for non-adherence 16 to this medication and increased reliance on riskier medications for pain management.…”

Section: Discussionmentioning

confidence: 99%