The Prognostic Impact of Psychotropic Drugs in Intentional Drug Overdose

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.

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Correspondence