Trends in antidepressant overdoses

Mary S. McKenzie, Bentson McFarland

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background: Debate continues about antidepressants and suicide. However, there are few recent nation-wide data about antidepressant overdoses. The purpose of this study was to describe United States trends from 1983 through 2003 in antidepressant overdoses as well as trends in health care utilization and mortality. Methods: Data were obtained from the American Association of Poison Control Centers' (AAPPC) Toxic Exposure Surveillance System (TESS), the National Hospital Ambulatory Medical Care Survey (NHAMCS) of emergency departments, and the National Hospital Discharge Survey(NHDS). Results: Antidepressant overdose reports rose dramatically in the United States (from 0.61 per 10000 population in 1983 to 3.26 per 10000 population in 2003) chiefly due to the rise in selective serotonin reuptake inhibitor (SSRI) ingestion. However, fatalities per antidepressant overdose report declined from 73 per 10000 reported ingestions to 32 per 10000 ingestions. Tricyclic antidepressant (TCA) overdoses had higher rates of hospitalization (78.7 vs. 64.7% hospitalized) and much higher fatality rates than did SSRI overdose reports (0.73 vs. 0.14% mortality). If the 55 977 SSRI overdoses in 2003 had represented TCA overdoses, then (other things being equal) approximately 410 fatalities would have been expected but only 106 people died. Emergency department visits associated with antidepressant overdose increased along with all emergency department visits. Hospitalization associated with antidepressant overdose increased in the early 1980s but then reached a plateau while overall hospitalizations declined. Conclusions: The dramatic rise in United States antidepressant overdoses has not been reflected in antidepressant overdose fatalities nor in hospitalizations. If the marked increase in antidepressant overdoses in the United States had involved TCAs rather than SSRIs, then there would have been roughly 300 excess deaths annually.

Original languageEnglish (US)
Pages (from-to)513-523
Number of pages11
JournalPharmacoepidemiology and Drug Safety
Volume16
Issue number5
DOIs
StatePublished - May 2007

Fingerprint

Antidepressive Agents
Serotonin Uptake Inhibitors
Hospitalization
Health Care Surveys
Hospital Emergency Service
Eating
Tricyclic Antidepressive Agents
Patient Acceptance of Health Care
Poison Control Centers
Mortality
Poisons
Suicide
Population

Keywords

  • Overdose
  • Selective serotonin reuptake inhibitors
  • Suicide
  • Tricyclic antidepressants

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Trends in antidepressant overdoses. / McKenzie, Mary S.; McFarland, Bentson.

In: Pharmacoepidemiology and Drug Safety, Vol. 16, No. 5, 05.2007, p. 513-523.

Research output: Contribution to journalArticle

McKenzie, MS & McFarland, B 2007, 'Trends in antidepressant overdoses', Pharmacoepidemiology and Drug Safety, vol. 16, no. 5, pp. 513-523. https://doi.org/10.1002/pds.1355
McKenzie, Mary S. ; McFarland, Bentson. / Trends in antidepressant overdoses. In: Pharmacoepidemiology and Drug Safety. 2007 ; Vol. 16, No. 5. pp. 513-523.
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