Deliberate self-harm and antidepressant drugs. Investigation of a possible link.
BACKGROUND
It is not clear if the frequency of deliberate self-harm (DSH) is the same in patients taking different pharmacological classes of antidepressant drugs.


OBJECTIVE
To compare the frequency of DSH in patients who had been prescribed a tricyclic antidepressant (TCA) or a selective serotonin reuptake inhibitor (SSRI) prior to the DSH event.


METHODS
This was a prospective study in 2776 consecutive DSH cases attending an accident and emergency department. The incidence of DSH in TCA-treated cases and SSRI-treated cases is expressed as number of DSH events per 10 000 prescriptions of each antidepressant.


RESULTS
Significantly more DSH events occurred following the prescription of an SSRI than that of a TCA (P<0.001). The occurrence of DSH was highest with fluoxetine and lowest with amitriptyline.


CONCLUSIONS
Merely prescribing safer-in-overdose antidepressants is unlikely to reduce the overall morbidity from DSH.
Donovan
S
S
School of Community Health Sciences, Division of Public Health medicine and Epidemiology, University Hospital, Queen's Medical Centre, Nottingham. mercedes@redmerc.freeserve.co.uk
Clayton
A
A
Beeharry
M
M
Jones
S
S
Kirk
C
C
Waters
K
K
Gardner
D
D
Faulding
J
J
Madeley
R
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D015331:Cohort Studies; D062787:Drug Overdose / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011446:Prospective Studies; D012652:Self Mutilation / Q000139:chemically induced*; D017367:Selective Serotonin Reuptake Inhibitors / Q000506:poisoning*
D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors