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How safe are psychiatric medications after a voluntary overdose?

Published online by Cambridge University Press:  16 April 2020

Enrique Baca-García ,
Carmen Diaz-Sastre ,
Jeronimo Saiz-Ruiz  and
Jose de Leon
Enrique Baca-García
Affiliation:
Department of Psychiatry, Hospital Ramon y Cajal, University of Alcala, Madrid, Spain
Carmen Diaz-Sastre
Affiliation:
Department of Psychiatry, Hospital Ramon y Cajal, University of Alcala, Madrid, Spain
Jeronimo Saiz-Ruiz
Affiliation:
Department of Psychiatry, Hospital Ramon y Cajal, University of Alcala, Madrid, Spain
Jose de Leon*
Affiliation:
Mental Health Research Center at Eastern State Hospital, 627 West Fourth Street, Lexington, KY 40508, USA
*
*Corresponding author. E-mail address: jdeleon@uky.edu (J. de Leon).
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Summary

Purpose.

This study assessed psychiatric medications and their potential lethality in a representative sample of suicide attempts.

Materials and methods.

During 1996–98, 563 suicide attempts were studied in a general hospital in Madrid (Spain). Medication overdose was used in 456 suicide attempts (81%). The ratio between dose taken and maximum prescription dose recommended was used to evaluate the medication toxicity.

Results.

Benzodiazepines were the drugs most often used in self-poisoning (65% of overdoses), followed by new antidepressants (11%), tricyclic antidepressants (TCAs) (10%), and antipsychotics (8%). An overdose with any of the three latter psychiatric medications was significantly more frequent in patients prescribed those medications. The overdoses for TCA were potentially lethal in 47% of the cases. However, all patients who overdosed on psychiatric medications recovered well and were discharged without any sequelae.

Discussion.

This study suggests that psychiatric medications, particularly benzodiazepines, new antidepressants and antipsychotics, are relatively safe when they are used for self-poisoning. If patients with mental illnesses are under treated, there is a clear and documented higher risk for suicide.

Conclusion.

It is better to prescribe psychiatric medications, particularly the new ones, rather than withhold them due to an exaggerated fear of a lethal overdose

Keywords

SuicideSuicide attemptsSelf-poisoningPsychiatric drugsOverdoseMortality
Type
Original Article
Information
European Psychiatry , Volume 17 , Issue 8 , December 2002 , pp. 466 - 470
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2002

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