Battersby M W, O'Mahoney J J, Beckwith A R, Hunt J L
Flinders University of South Australia, Bedford Park, Australia.
Aust N Z J Psychiatry. 1996 Apr;30(2):223-8. doi: 10.3109/00048679609076098.
To determine the prevalence of antidepressant deaths in South Australia, the relative frequency of each antidepressant used and demographic data of those who died.
This was a retrospective, case note study of all cases where death was caused by lethal levels of antidepressants in South Australia for the period from 1986 to 1990. The study occurred at the South Australian coroner's office. Subjects were selected from toxicology data, where serum or liver levels of one or more antidepressant were in the lethal range.
Seventy-one cases were identified and information was obtained on 68 of these cases from the coroner's files. Amitriptyline, Doxepin and Dothiepin accounted for the majority of antidepressant deaths. Women were 2.5 times more likely to use antidepressants to suicide than men. At least 63% had a known psychiatric illness and 45% had previously attempted suicide.
The older tricyclic antidepressants are a significant cause of suicide. It is recommended that the newer antidepressants, which are as efficacious yet safer in overdose, be prescribed in preference to the older tricyclic antidepressants, as the first line of treatment in newly diagnosed depressed outpatients.
确定南澳大利亚州抗抑郁药致死的发生率、每种抗抑郁药的使用相对频率以及死亡者的人口统计学数据。
这是一项回顾性病例记录研究，研究对象为1986年至1990年期间南澳大利亚州所有因抗抑郁药致死剂量导致死亡的病例。该研究在南澳大利亚州验尸官办公室进行。研究对象从毒理学数据中选取，即血清或肝脏中一种或多种抗抑郁药的水平处于致死范围的情况。
共确定71例病例，从验尸官档案中获取了其中68例的信息。阿米替林、多塞平和度硫平占抗抑郁药致死病例的大多数。女性使用抗抑郁药自杀的可能性是男性的2.5倍。至少63%的人患有已知精神疾病，45%的人曾有过自杀未遂史。
较老的三环类抗抑郁药是自杀的一个重要原因。建议在新诊断的门诊抑郁症患者的一线治疗中，优先处方在过量服用时同样有效但更安全的新型抗抑郁药，而非较老的三环类抗抑郁药。
