Prescott L F, Highley M S
Br Med J (Clin Res Ed). 1985 Jun 1;290(6482):1633-6. doi: 10.1136/bmj.290.6482.1633.
Of 230 adults admitted for self poisoning over two months, 153 (67%) had previously been taking a total of 309 prescribed drugs. Of these patients, 119 (78%) had been given psychotropic drugs (usually benzodiazepines), 81 (53%) obtained them on repeat prescription, and 47 (31%) had been prescribed multiple psychotropic drugs, often in seemingly illogical combinations. The use of these drugs increased progressively with age and most patients took the same drugs in overdosage as they had been prescribed. Psychotropic drugs were prescribed for more than a third of patients with no psychiatric illness and a normal personality, nearly half of those with existing alcohol or drug abuse problems, and for most of the unemployed. Fewer than a third of the patients suffering from depression were prescribed antidepressants but half had been given benzodiazepines and other potentially depressing drugs. Psychotropic drug use, psychotropic polypharmacy, and the repeat prescribing of these drugs were strongly associated with repeated overdosage and, under certain circumstances, with personality disorder, alcohol or drug abuse, unemployment, and conflict with the law. In the long term psychotropic drugs are unlikely to benefit most self poisoners, and they may do positive harm by inducing apathy and depression and predisposing to self poisoning. The incidence of self poisoning (and repeat overdosage in particular) might be reduced by more care and restraint in the prescribing of these drugs.
在两个月内因自我中毒入院的230名成年人中,153人(67%)此前一直在服用总计309种处方药。在这些患者中,119人(78%)曾服用过精神药物(通常是苯二氮䓬类药物),81人(53%)通过重复处方获得这些药物,47人(31%)曾被开具多种精神药物,且常常是看似不合理的组合。这些药物的使用随年龄增长而逐渐增加,大多数患者过量服用的药物与他们之前被开具的药物相同。超过三分之一没有精神疾病且性格正常的患者、近一半有酗酒或药物滥用问题的患者以及大多数失业者都被开具了精神药物。患有抑郁症的患者中,不到三分之一被开具了抗抑郁药,但一半患者被给予了苯二氮䓬类药物和其他可能导致抑郁的药物。精神药物的使用、多种精神药物联用以及这些药物的重复开具与反复过量用药密切相关,在某些情况下,还与人格障碍、酗酒或药物滥用、失业以及违法冲突有关。从长远来看,精神药物对大多数自我中毒者不太可能有益,它们可能会通过导致冷漠和抑郁并使人易患自我中毒而造成实际伤害。在开具这些药物时更加谨慎和克制,可能会降低自我中毒(尤其是反复过量用药)的发生率。