Antidepressant-related deaths and antidepressant prescriptions in England and Wales, 1998-2000
Antidepressant-related deaths and antidepressant prescriptions in England and Wales, 1998-2000
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DOI：
10.1192/bjp.184.1.41
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发表时间：
2004-01-01
影响因子：
10.5
通讯作者：
Ghodse, AH
中科院分区：
文献类型：
--
作者：
Cheeta, S;Schifano, F;Ghodse, AH
背景抗抑郁药的死亡仍然占药物相关死亡的相当大的比例，目的是调查主要类别的抗抑郁药的相对毒性，具体目的是评估这与死亡原因的关系;并分析多次提及抗抑郁药或其他精神活性药物与抗抑郁药的死亡情况。结果抗抑郁药物所致的死亡以自杀为主（80%）。三环类抗抑郁药（TCAs）比其他抗抑郁药（12/百万处方）占更多的药物提及。选择性5-羟色胺再摄取抑制剂（SSRIs）与毒性风险显著降低相关，但93%的SSRIs死亡发生在与其他药物联合使用时，特别是TCA（24.5%）。在“组合”死亡的患者更有可能有一个历史的药物misside.Conclusions的有效性和安全性的增强治疗与TCAs SSRI耐药的患者应仔细监测，和患者处方抗抑郁药应筛选药物使用/misside.Declaration的利益无。
Background Deaths from antidepressants continue to account for a substantial proportion of drug-related deaths.Aims To investigate the relative toxicity of the major classes of antidepressant drugs, with the specific objective of assessing this in relation to the cause of death; and to analyse the deaths where there were multiple mentions of antidepressant drugs or other psychoactive drugs with antidepressants.Method Mortality data were collected from the National Programme of Substance Abuse Deaths, and antidepressant prescription data were collected.Results Most deaths from antidepressant drugs were suicides (80%). Tricyclic antidepressants (TCAs) accounted for more drug mentions than did other antidepressant drugs (12 per million prescriptions). Selective serotonin reuptake inhibitors (SSRIs) were associated with a significantly lower risk of toxicity, but 93% of deaths from SSRIs occurred in combination with other drugs, especially TCAs (24.5%). In 'combination' deaths patients were significantly more likely to have had a history of drug misuse.Conclusions The efficacy and safety of augmentation therapy with TCAs in SSRI-resistant patients should be monitored carefully, and patients prescribed antidepressants should be screened for drug use/misuse.Declaration of interest None.