The prognostic impact of psychotropic drugs in intentional drug overdose.
BACKGROUND
Psychotropic drugs belong to the drugs most frequently involved in intentional drug overdose (IDO). Few studies have explored their prognostic impact during hospitalisation for IDO.


METHODS
In order to assess which types of psychotropic drugs ingested during IDOs were associated with an increased morbidity, a cohort study included 1,974 patients consecutively hospitalised for IDO. IDOs were categorised as serious if associated with one of the following criteria: death, hospitalisation longer than 48 h, respiratory support, vasopressive drugs, cardiac massage or dialysis.


RESULTS
Nearly all the patients ingested psychotropic medications during the IDO (88.4%), most often benzodiazepines (71.6%). Serious IDO was associated with tricyclics (OR 5.7; 95% CI 3.3-9.8), lithium (OR 4.3; 95% CI 1.6-11.6), carbamates (OR 2.7; 95% CI 1.8-4), anticonvulsants (OR 2.4: 95% CI 1.4-4.3), first-generation antipsychotics (OR 2.4; 95% CI 1.7-3.5) or selective serotonin reuptake inhibitors (SSRIs) (OR 1.6; 95% CI 1.1-2.3).


CONCLUSIONS
Some drugs may be dangerous because of low toxic doses; hence, prescriptions of short duration may be recommended. Moreover, for safety reasons, prescribers may prefer SSRIs to tricyclics and benzodiazepines to carbamates or phenothiazines.
Tournier
M
M
Unité INSERM U657, Université Victor Segalen, Hôpital Charles Perrens, Bordeaux, France. mtournier@ch-perrens.fr
Grolleau
A
A
Cougnard
A
A
Verdoux
H
H
Molimard
M
M
D000328:Adult; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D000928:Antidepressive Agents / Q000008:administration & dosage; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage; D018692:Antimanic Agents / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000008:administration & dosage; D001569:Benzodiazepines / Q000008:administration & dosage; D002219:Carbamates / Q000008:administration & dosage; D002423:Cause of Death; D015331:Cohort Studies; D062787:Drug Overdose / Q000150:complications* / Q000209:etiology; D011307:Drug Prescriptions; D005260:Female; D006760:Hospitalization; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D018020:Lithium Compounds / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011619:Psychotropic Drugs / Q000008:administration & dosage* / Q000009:adverse effects; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage; D012720:Severity of Illness Index; D013406:Suicide, Attempted / Q000523:psychology*
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D002219:Carbamates; D006993:Hypnotics and Sedatives; D018020:Lithium Compounds; D011619:Psychotropic Drugs; D017367:Selective Serotonin Reuptake Inhibitors; C070766:carbamic acid