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Antidepressant deaths by overdose
M W Battersby1, J J O'Mahoney, A R Beckwith
1Flinders University of South Australia, Bedford Park, Australia.
The Australian and New Zealand Journal of Psychiatry
|April 1, 1996
Summary
Older antidepressants, particularly tricyclic antidepressants, are a significant cause of suicide deaths. Newer, safer alternatives are recommended for initial treatment of depression to reduce mortality.
Area of Science:
- Toxicology
- Psychiatry
- Epidemiology
Background:
- Antidepressant use is common in treating depression.
- Suicide remains a significant public health concern.
- Understanding patterns of antidepressant-related deaths is crucial for prevention.
Purpose of the Study:
- Determine the prevalence of antidepressant deaths in South Australia.
- Identify the relative frequency of specific antidepressants involved in fatalities.
- Analyze demographic data of individuals who died from antidepressant overdose.
Main Methods:
- Retrospective case note study of all antidepressant-induced deaths in South Australia (1986-1990).
- Data sourced from the South Australian coroner's office and toxicology reports.
- Inclusion criteria: lethal levels of one or more antidepressants identified in serum or liver samples.
Main Results:
- 71 cases of antidepressant deaths identified; data analyzed for 68.
- Amitriptyline, Doxepin, and Dothiepin were the most frequent antidepressants implicated.
- Women were 2.5 times more likely to die by suicide using antidepressants than men.
- A majority (63%) had a known psychiatric illness, and 45% had a history of suicide attempts.
Conclusions:
- Older tricyclic antidepressants represent a significant cause of suicide.
- Recommends prescribing newer, safer antidepressants as first-line treatment for newly diagnosed outpatients.
- Safer alternatives offer comparable efficacy with reduced overdose risk.