抗抑郁药物和自杀企图和自杀的相对风险
S Kapur1, T Mieczkowski, J J Mann
1Laboratory of Neuropharmacology, Western Psychiatric Institute and Clinic, University of Pittsburgh, PA.
JAMA
|December 23, 1992
概括
三环抗抑郁药与与较新的抗抑郁药相比,过量服用的死亡率更高. 德西普拉明化水表现为最高风险,需要进一步研究患者的安全性.
科学领域:
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
- 毒理学 毒理学 毒理学
背景情况:
- 药物过量自杀是一个重大的公共卫生问题,抗抑郁药物通常参与其中.
- 之前的欧洲研究表明,抗抑郁药物过量自杀率在抗抑郁药物中存在差异,但美国数据缺乏.
研究的目的:
- 为了估计自杀未遂和美国抗抑郁药过量自杀的比较风险.
- 确定在美国销售的主要抗抑郁药物过量服用后死亡的相对风险.
主要方法:
- 利用了药物滥用和警告网络 (DAWN) 和美国毒药控制中心协会 (AAPCC) 的数据.
- 通过使用国家处方审计 (NPA) 的信息,对处方量进行过量剂量数据的纠正.
主要成果:
- 不同的抗抑郁药物之间没有观察到自杀企图率的显著差异.
- 三环抗抑郁药 (TCA) 显示,与较新的非三环抗抑郁药相比,在过量服用的情况下,死亡率更高.
- 德西普拉明化与其他TCA相比,在过量服用后死亡的可能性更大.
结论:
- 用TCA增加的自杀风险可能源于高过量死亡率,不一定是更多的尝试.
- TCA具有更大的心脏毒性,导致过量死亡率.
- 过量服用desipramine的高死亡率需要进一步调查,以了解其潜在的机制.
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