How safe are psychiatric medications after a voluntary overdose?
OBJECTIVE
This study assessed psychiatric medications and their potential lethality in a representative sample of suicide attempts.


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.


CONCLUSIONS
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.


CONCLUSIONS
It is better to prescribe psychiatric medications, particularly the new ones, rather than withhold them due to an exaggerated fear of a lethal overdose
Baca-García
Enrique
E
Department of Psychiatry, Hospital Ramon y Cajal, University of Alcala, Madrid, Spain.
Diaz-Sastre
Carmen
C
Saiz-Ruiz
Jeronimo
J
de Leon
Jose
J
D000328:Adult; D062787:Drug Overdose; D005260:Female; D006801:Humans; D008297:Male; D011619:Psychotropic Drugs / Q000009:adverse effects* / Q000506:poisoning; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data
D011619:Psychotropic Drugs