Malmvik J, Löwenhielm C G, Melander A
Department of Forensic Medicine, University of Lund, Sweden.
Eur J Clin Pharmacol. 1994;46(4):291-4. doi: 10.1007/BF00194393.
All forensic autopsy cases in southern Sweden in 1986-89 in which antidepressant drugs were found in the blood were assessed and the findings related to the sales of antidepressants as expressed as defined daily doses per 1,000 inhabitants per day. There was a total of 272 antidepressant-positive cases, which were divided in three groups: 1. suicide or possible suicide caused by antidepressant drugs, 2. suicide or possible suicide caused by other means (including other drugs and other toxic agents), and 3. other deaths. Amitriptyline was the agent most commonly involved in suicide or possible suicide caused by antidepressants, and it was also the most commonly sold antidepressant. When corrected for sales, trimipramine was most frequently involved as the causal agent. Conversely, despite frequent sales, lofepramine appeared only rarely to be involved. This may be related to lower toxicity of lofepramine, reduced lofepramine absorption at overdose and/or to differences in the administration of various antidepressant drugs to patients with differing degrees of risk of suicide.
对1986 - 1989年瑞典南部所有法医尸检案例进行了评估，这些案例中血液里发现了抗抑郁药物，并将调查结果与抗抑郁药物的销售情况相关联，销售情况以每千居民每天的限定日剂量来表示。总共有272例抗抑郁药呈阳性的案例，这些案例被分为三组：1. 由抗抑郁药物导致的自杀或可能自杀；2. 由其他方式（包括其他药物和其他有毒物质）导致的自杀或可能自杀；3. 其他死亡情况。阿米替林是抗抑郁药物导致自杀或可能自杀案例中最常涉及的药物，同时它也是销售最普遍的抗抑郁药。经销售情况校正后，三甲丙咪嗪作为致病药物最常出现。相反，尽管洛非帕明销量很大，但它似乎很少导致此类情况。这可能与洛非帕明较低的毒性、过量服用时洛非帕明吸收减少和/或给不同自杀风险程度患者使用各种抗抑郁药物的方式差异有关。
