Pharmacopsychiatry 2009; 42(2): 51-56
DOI: 10.1055/s-0028-1100426
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

The Prognostic Impact of Psychotropic Drugs in Intentional Drug Overdose

M. Tournier 1 , A. Grolleau 1 , A. Cougnard 1 , H. Verdoux 1 , M. Molimard 1
  • 1Unité INSERM U657; Université Victor Segalen, Bordeaux, France
Further Information

Publication History

received 25.04.2008 revised 21.07.2008

accepted 04.08.2008

Publication Date:
23 March 2009 (online)

Zoom Image

Abstract

Introduction: 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).

Discussion: 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.