[Poisonings with antidepressants]

In 2019 the Swedish Poisons Information Centre (SPIC) was contacted in 1 198 hospital cases of intentional poisonings with antidepressants. Severe poisonings identified using the Poison Severity Score were divided by the number of prescriptions for the respective antidepressant per 1 000 inhabitants, yielding a substance specific poisoning severity index (PSI). Amitriptyline, clomipramine, venlafaxine and bupropion had PSIs surpassing all other antidepressants by nearly an order of magnitude and comprised almost 80% of 101 serious poisonings. The same substances also scored very high in a suicide mortality index calculated by dividing the 81 antidepressant suicide deaths identified by the National Board of Forensic Medicine (NBFM) in 2019 by prescription rates. Both the SPIC and the NBFM cohorts demonstrate that the risk of severe toxicity from overdose is not uniform among antidepressants. The toxicity profile of the respective substance needs to be considered when antidepressants are prescribed.