The cost of antidepressant overdose.
Ninety percent of suicide attempts referred to a general hospital are by self-poisoning. Among women, drug overdose is the commonest means of suicide. In a retrospective naturalistic review of 200 patients who were treated in the Critical Care Unit of a general hospital following medication overdose, 12% were antidepressant overdoses. The mean duration of hospital stay for overdose with tricyclic antidepressants (TCA) was more than double that for overdose with selective serotonin reuptake inhibitors (SSRI) (7 vs 3 days; z = 2.20, p < 0.05). The dollar cost of hospital treatment for patients who overdosed on TCAs was four times greater than that for patients who overdosed on SSRIs ($22,923 vs $5,379; z = 2.30, p < 0.05). The tricyclic compounds clearly have a price advantage over more recently introduced antidepressant agents fluoxetine, sertraline, paroxetine, venlafaxine, and bupropion. The apparent cost advantage of prescribing a less expensive drug may be nullified by the cost associated with adverse consequences.
D'Mello
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DA
Department of Psychiatry, Michigan State University, Lansing, USA.
Finkbeiner
D S
DS
Kocher
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KN
D000928:Antidepressive Agents / Q000191:economics / Q000506:poisoning*; D018687:Antidepressive Agents, Second-Generation / Q000191:economics / Q000506:poisoning; D003365:Costs and Cost Analysis; D003422:Critical Care / Q000191:economics; D062787:Drug Overdose / Q000191:economics* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008824:Michigan; D012189:Retrospective Studies; D013406:Suicide, Attempted / Q000191:economics* / Q000517:prevention & control / Q000523:psychology; D016896:Treatment Outcome
D000928:Antidepressive Agents; D018687:Antidepressive Agents, Second-Generation