title: Self-poisonings with tricyclic antidepressants and selective serotonin reuptake inhibitors in Tehran, Iran.
abstract: In a prospective hospital-based cohort study, we addressed the question of severity and outcome of antidepressant poisonings in patients who attended the Loghman-Hakim Hospital Poison Center, the only national center in Tehran dedicated for detoxification. The aim of the study was to find out if tricyclic antidepressant (TCA) intoxications require more therapeutic efforts than selective serotonin reuptake inhibitor (SSRI) intoxications. The study was applied over a 7-week period (28 March-20 May 2006). From 3578 intoxications, 334 patients with antidepressant or lithium self-poisoning were identified (9.3% of all poisoning cases; 233 females, 101 males; median age 24 years, min 13, max 70). Compared to SSRI single-substance intoxications (n=17), TCA single-substance intoxications (n=73) were associated with: (1) a significantly lower level of consciousness (P=0.005); (2) a significantly higher admission frequency (80.8 vs. 35.3%; P<0.001); and (3) a higher intubation frequency (13.7 vs. 0%; P=ns). SSRI multiple-substance intoxications were associated with a significantly lower level of consciousness than SSRI single-substance intoxications (P=0.042), while there was no significant difference between TCA multiple- and single-substance intoxications. This study suggests that an overdose with SSRIs results in a more favourable clinical outcome than an overdose with TCAs.
authors.affiliation: Department of Psychiatry and Psychotherapy, Division of Biological Psychiatry, Medical University of Vienna, A-1090 Vienna, Austria. angela.naderi-heiden@meduniwien.ac.at
authors.forename: Angela
authors.initials: A
authors.lastname: Naderi-Heiden
authors.forename: Shahin
authors.initials: S
authors.lastname: Shadnia
authors.forename: Ali-Reza
authors.initials: AR
authors.lastname: Salimi
authors.forename: Ahmad
authors.initials: A
authors.lastname: Naderi
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Naderi
authors.forename: Daniela
authors.initials: D
authors.lastname: Schmid
authors.forename: Andreas
authors.initials: A
authors.lastname: Gleiss
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
authors.forename: Richard
authors.initials: R
authors.lastname: Frey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000506:poisoning; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D015331:Cohort Studies; D003128:Coma / Q000139:chemically induced / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D062787:Drug Overdose / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D007492:Iran; D016651:Lithium Carbonate / Q000506:poisoning; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D011039:Poison Control Centers / Q000706:statistics & numerical data; D011041:Poisoning / Q000453:epidemiology*; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000506:poisoning; D017367:Selective Serotonin Reuptake Inhibitors / Q000506:poisoning; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D016651:Lithium Carbonate; D011619:Psychotropic Drugs; D017367:Selective Serotonin Reuptake Inhibitors