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Trends in antidepressant overdoses.
Mary S McKenzie1, Bentson H McFarland
1Department of Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA.
Pharmacoepidemiology and Drug Safety
|January 4, 2007
Summary
Antidepressant overdoses significantly increased in the US, but fatalities and hospitalizations did not rise proportionally, largely due to the shift from TCAs to SSRIs. This shift has saved lives, preventing hundreds of deaths annually.
Area of Science:
- Public Health
- Toxicology
- Pharmacovigilance
Background:
- Ongoing debate surrounds antidepressants and suicide rates.
- Limited recent national data exist on antidepressant overdose trends.
- This study addresses the need for updated information on antidepressant overdoses and their outcomes.
Purpose of the Study:
- To describe US trends in antidepressant overdoses from 1983 to 2003.
- To analyze trends in healthcare utilization for overdoses.
- To examine mortality rates associated with antidepressant overdoses.
Main Methods:
- Utilized data from the American Association of Poison Control Centers (AAPPC) Toxic Exposure Surveillance System (TESS).
- Incorporated data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) for emergency department visits.
- Included data from the National Hospital Discharge Survey (NHDS) for hospitalizations.
Main Results:
- Antidepressant overdose reports surged from 0.61 to 3.26 per 10,000 population (1983-2003), driven by selective serotonin reuptake inhibitor (SSRI) ingestion.
- Fatalities per overdose report decreased significantly, from 73 to 32 per 10,000 ingestions.
- Tricyclic antidepressant (TCA) overdoses showed higher hospitalization (78.7% vs. 64.7%) and mortality rates (0.73% vs. 0.14%) compared to SSRI overdoses.
Conclusions:
- Despite a dramatic rise in US antidepressant overdoses, fatalities and hospitalizations remained stable.
- The increased use of SSRIs over TCAs has likely prevented substantial annual fatalities.
- The shift to SSRIs may have averted approximately 300 excess deaths annually.
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