[抗抑郁药在蓄意自我中毒中的重要性日益增加]

[Increasing significance of antidepressants in deliberate self-poisoning].

作者信息

Von Mach M A, Weilemann L S

机构信息

Klinische Toxikologie und Beratungsstelle bei Vergiftungen, II. Medizinische Klinik und Poliklinik, Klinikum der Johannes Gutenberg-Universität Mainz, Germany.

出版信息

Dtsch Med Wochenschr. 2002 Oct 4;127(40):2053-6. doi: 10.1055/s-2002-34512.

DOI:10.1055/s-2002-34512

PMID:12373636

Abstract

BACKGROUND AND OBJECTIVE

Antidepressant drugs are frequently used in deliberate self-poisoning resulting in a major risk for the patients due to their cardiac and central-nervous toxicity. In the present study the cases of intoxications consulting our Poison Center should be analysed illustrating recent results and trends about self-poisoning with antidepressants.

PATIENTS AND METHODS

During the study period from 1995 to 2001 35 394 inquiries concerning deliberate self-poisoning were registered in our Poison Center. The substance used, age and gender of the patient as well as the degree of the observed symptoms were documented. Thereby, antidepressant drugs were grouped in tricyclic antidepressants (TCA), selective serotonin reuptake inhibitors (SSRI) and other antidepressants.

RESULTS

The use of antidepressants in deliberate self-poisoning continuously increased during the study period from 17.3 % to 22.9 % with SSRI and other antidepressants being observed more frequently as compared to TCA. Antidepressant drugs were mainly used from female patients and in the age group between 35 and 54 years. Antidepressant drugs caused severe intoxications and deaths more frequently as the remainder substances with TCA showing higher rates of complications as compared to SSRI and other antidepressants.

CONCLUSIONS

In recent years, an increasing importance of antidepressant drugs in deliberate self-poisoning was determined particularly concerning female and middle-aged patients. Due to the changing prescribing patterns larger numbers of intoxications with SSRI and other antidepressants were observed representing an advantage with respect to the reduced rate of complications known for these substances as compared to TCA. Nevertheless, the averagely more severe symptoms present in the three groups of antidepressants in comparison to the remainder drug overdoses demonstrated the need for hospitalization and monitoring of intoxications with antidepressants.

摘要

背景与目的

抗抑郁药物常用于蓄意自我中毒，因其心脏和中枢神经毒性，给患者带来重大风险。在本研究中，应对向我们中毒控制中心咨询中毒情况的病例进行分析，以阐明近期抗抑郁药物自我中毒的结果和趋势。

患者与方法

在1995年至2001年的研究期间，我们中毒控制中心共登记了35394例关于蓄意自我中毒的咨询。记录了患者使用的物质、年龄、性别以及观察到的症状程度。据此，抗抑郁药物分为三环类抗抑郁药（TCA）、选择性5-羟色胺再摄取抑制剂（SSRI）和其他抗抑郁药。

结果

在研究期间，抗抑郁药物在蓄意自我中毒中的使用持续增加，从17.3%增至22.9%，与TCA相比，SSRI和其他抗抑郁药的使用更为频繁。抗抑郁药物主要由女性患者使用，年龄在35至54岁之间。与其他物质相比，抗抑郁药物导致严重中毒和死亡的情况更为频繁，其中TCA的并发症发生率高于SSRI和其他抗抑郁药。

结论

近年来，已确定抗抑郁药物在蓄意自我中毒中的重要性日益增加，尤其是在女性和中年患者中。由于处方模式的变化，观察到更多SSRI和其他抗抑郁药中毒病例，与TCA相比，这些物质已知的并发症发生率较低，这是一个优势。然而，与其他药物过量相比，三组抗抑郁药平均症状更为严重，这表明有必要对抗抑郁药中毒患者进行住院治疗和监测。