The prognostic impact of psychotropic drugs in intentional drug overdose

Pharmacopsychiatry. 2009 Mar;42(2):51-6. doi: 10.1055/s-0028-1100426. Epub 2009 Mar 23.

Abstract

Introduction: Psychotropic drugs belong to the drugs most frequently involved in intentional drug overdose (IDO). Few studies have explored their prognostic impact during hospitalisation for IDO.

Methods: In order to assess which types of psychotropic drugs ingested during IDOs were associated with an increased morbidity, a cohort study included 1,974 patients consecutively hospitalised for IDO. IDOs were categorised as serious if associated with one of the following criteria: death, hospitalisation longer than 48 h, respiratory support, vasopressive drugs, cardiac massage or dialysis.

Results: Nearly all the patients ingested psychotropic medications during the IDO (88.4%), most often benzodiazepines (71.6%). Serious IDO was associated with tricyclics (OR 5.7; 95% CI 3.3-9.8), lithium (OR 4.3; 95% CI 1.6-11.6), carbamates (OR 2.7; 95% CI 1.8-4), anticonvulsants (OR 2.4: 95% CI 1.4-4.3), first-generation antipsychotics (OR 2.4; 95% CI 1.7-3.5) or selective serotonin reuptake inhibitors (SSRIs) (OR 1.6; 95% CI 1.1-2.3).

Discussion: Some drugs may be dangerous because of low toxic doses; hence, prescriptions of short duration may be recommended. Moreover, for safety reasons, prescribers may prefer SSRIs to tricyclics and benzodiazepines to carbamates or phenothiazines.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Anxiety Agents / administration & dosage
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents, Tricyclic / administration & dosage
  • Antimanic Agents / administration & dosage
  • Antipsychotic Agents / administration & dosage
  • Benzodiazepines / administration & dosage
  • Carbamates / administration & dosage
  • Cause of Death
  • Cohort Studies
  • Drug Overdose / complications*
  • Drug Overdose / etiology
  • Drug Prescriptions*
  • Female
  • Hospitalization
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Lithium Compounds / administration & dosage
  • Male
  • Middle Aged
  • Prognosis
  • Psychotropic Drugs / administration & dosage*
  • Psychotropic Drugs / adverse effects
  • Risk Factors
  • Selective Serotonin Reuptake Inhibitors / administration & dosage
  • Severity of Illness Index
  • Suicide, Attempted / psychology*

Substances

  • Anti-Anxiety Agents
  • Antidepressive Agents
  • Antidepressive Agents, Tricyclic
  • Antimanic Agents
  • Antipsychotic Agents
  • Carbamates
  • Hypnotics and Sedatives
  • Lithium Compounds
  • Psychotropic Drugs
  • Serotonin Uptake Inhibitors
  • Benzodiazepines
  • carbamic acid