Crome P
Poisons Unit, Guy's Hospital London, United Kingdom.
Acta Psychiatr Scand Suppl. 1993;371:33-7. doi: 10.1111/j.1600-0447.1993.tb05371.x.
Death from suicidal drug overdose differs from other forms of suicide in that the drugs are often prescribed by the patient's physician. In 1987, 3 of the 12 most commonly taken drugs in completed suicide were antidepressants (dothiepin, amitriptyline and imipramine). Antidepressants account for approximately 15% of all drug overdoses. The differences in toxicity between antidepressants have been measured using fatal toxicity indices, which relate the number of deaths and the amount of drug prescribed. Results from the United Kingdom covering the years 1975 to 1986 have shown that older tricyclic antidepressants have a fatal toxicity index 5 to 8 times higher than that of new antidepressants such as mianserin. The limitation of barbiturate prescribing has been followed by a fall in deaths from these drugs. Hopefully in the future it might be possible either to prescribe less toxic antidepressants or to identify the patients at greatest risk of drug suicide and to prescribe for them the least toxic drugs.
因过量服用药物自杀死亡与其他形式的自杀不同，在于这些药物往往是由患者的医生开具的。1987年，在完成自杀时最常服用的12种药物中，有3种是抗抑郁药（多塞平、阿米替林和丙咪嗪）。抗抑郁药约占所有药物过量服用案例的15%。抗抑郁药之间的毒性差异已通过致命毒性指数来衡量，该指数将死亡人数与所开药物剂量联系起来。英国1975年至1986年的结果表明，较老的三环类抗抑郁药的致命毒性指数比米安色林等新型抗抑郁药高5至8倍。巴比妥类药物处方量的限制导致了因这些药物死亡的人数下降。希望未来有可能要么开毒性较小的抗抑郁药，要么识别出药物自杀风险最高的患者，并为他们开毒性最小的药物。
