Pharmacotherapy of the suicidal patient

The incidence of self-poisoning and suicide accomplished with tricyclic antidepressants (TCA) is unacceptably high. TCA are undeniably highly toxic, and overdosage occurs frequently. This review presents data that more than suggest that the compounds are prescribed for patients for whom TCA treatment is not indicated. Therefore, the physicians must learn to face up to the benefit-risk elements with these drugs. As TCA for many years to come probably remain the drug of choice in treatment of many depressed patients, the only way out of this dilemma is to focus on prevention. In any event, more cautious prescribing of TCA outside hospital is desirable.