title: Clinical characteristics of patients who overdose on multiple psychotropic drugs in Tokyo.
abstract: OBJECTIVE
  The purpose of this study was to identify the clinical aspects leading to overdose of multiple psychotropic drugs, in order to determine areas which need attention in the proper treatment of overdose patients.
  
  
  METHODS
  Patients who were treated for overdose of psychotropic drugs at our emergency and critical center over two years were targeted. The clinical data was gathered from the medical records and database of all patients, including age, gender, vital signs, and laboratory data, drugs, and medical complications during hospital stay. In addition primary patient care at the emergency department was examined.
  
  
  RESULTS
  Among the 277 patients treated during this study period, 255 (74.0%) used two or more types of psychotropic drugs. Risk factors associated with endotracheal intubation and aspiration pneumonitis included the use of antipsychotics and/or barbiturates as types of overdose drugs. The mean number of days in the ICU was 3.4 days. Seventy-four patients (26.7%) stayed 4 days or more in the ICU of which 16 patients (5.8%) still had suicidal thoughts. A significantly higher incidence of extended ICU stay or endotracheal intubation and aspiration pneumonitis was observed in the group who overdosed on more than 50 or 60 tablets of psychotropic drugs, respectively.
  
  
  CONCLUSIONS
  Patients who ingested an overdose of more than 60 tablets of psychotropic drugs should be considered a high-risk group requiring intensive care with extended ICU stay. In case of including antipsychotics and/or barbiturates, the patient should be observed carefully due to a higher risk of medical complications.
authors.affiliation: Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hori
authors.forename: Kosaku
authors.initials: K
authors.lastname: Kinoshita
mesh_terms: D000328:Adult; D016208:Databases, Factual; D062787:Drug Overdose / Q000175:diagnosis / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000145:classification / Q000506:poisoning*; D012307:Risk Factors; D059020:Suicidal Ideation; D013406:Suicide, Attempted; D013997:Time Factors; D014041:Tokyo; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs