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首页> 外文期刊>The British journal of psychiatry : >Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose
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Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose

机译：抗抑郁药的毒性：相对于处方药和非致命过量用药的自杀率

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Background Self-poisoning is a common method of suicide and often involves ingestion of antidepressants. Information on the relative toxicity of antidepressants is therefore extremely important. Aims To assess the relative toxicity of specific tricyclic antidepressants (TCAs), a serotonin and noradrenaline reuptake inhibitor (SNRI), a noradrenergic and specific serotonergic antidepressant (NaSSA), and selective serotonin reuptake inhibitors (SSRIs). Method Observational study of prescriptions (UK), poisoning deaths involving single antidepressants receiving coronersa€? verdicts of suicide or undetermined intent (England and Wales) and non-fatal self-poisoning episodes presenting to six general hospitals (in Oxford, Manchester and Derby) between 2000 and 2006. Calculation of fatal toxicity index based on ratio of rates of deaths to prescriptions, and case fatality based on ratio of rates of deaths to non-fatal self-poisonings. Results Fatal toxicity and case fatality indices provided very similar results (rho for relative ranking of indices 0.99). Case fatality rate ratios showed greater toxicity for TCAs (13.8, 95% CI 13.0a€“14.7) than the SNRI venlafaxine (2.5, 95% CI 2.0a€“3.1) and the NaSSA mirtazapine (1.9, 95% CI 1.1a€“2.9), both of which had greater toxicity than the SSRIs (0.5, 95% CI 0.4a€“0.7). Within the TCAs, compared with amitriptyline both dosulepin (relative toxicity index 2.7) and doxepin (2.6) were more toxic. Within the SSRIs, citalopram had a higher case fatality than the other SSRIs (1.1, 95% CI 0.8a€“1.4 v. 0.3, 95% CI 0.2a€“0.4). Conclusions There are wide differences in toxicity not only between classes of antidepressants, but also within classes. The findings are relevant to prescribing decisions, especially in individuals at risk, and to regulatory policy.
机译：背景技术自体中毒是自杀的一种常见方法，通常涉及抗抑郁药的摄入。因此，有关抗抑郁药相对毒性的信息非常重要。目的评估特定的三环抗抑郁药（TCA），5-羟色胺和去甲肾上腺素再摄取抑制剂（SNRI），去甲肾上腺素能和特异性5-羟色胺能抗抑郁药（NaSSA）以及选择性5-羟色胺再摄取抑制剂（SSRIs）的相对毒性。方法处方（英国）的观察性研究，涉及接受验尸官的单一抗抑郁药的中毒死亡。在2000年至2006年期间对六家综合医院（位于牛津，曼彻斯特和德比）的自杀或意图未定（英格兰和威尔士）和非致命性自体中毒的判决。根据死亡率与死亡率的比率计算致命毒性指数处方药，以及根据死亡率与非致命性自我中毒比率得出的病死率。结果致命毒性和病死率指数提供了非常相似的结果（rho相对指数为0.99）。病例死亡率显示，三氯乙酸（TCA）（13.8，95％CI 13.0a“ 14.7”）比SNRI文拉法辛（2.5，95％CI 2.0a“ 3.1）和NaSSA米氮平（1.9，95％CI 1.1a€）毒性更大“ 2.9”，两者的毒性均比SSRIs（0.5，95％CI 0.4a？0.7）大。在三氯乙酸中，与阿米替林相比，dosulepin（相对毒性指数为2.7）和doxepin（2.6）的毒性更高。在SSRI中，西酞普兰的病死率高于其他SSRI（1.1，95％CI 0.8a€1.4 vs. 0.3，95％CI 0.2a€0.4）。结论不仅在抗抑郁药类别之间，而且在各类抗抑郁药之间，毒性都有很大差异。这些发现与制定决策有关，特别是对于处于危险中的个人，以及监管政策。

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