The Toxicity of Antidepressants in Overdose: Incidence and Mechanisms
- 1 January 1990
- journal article
- research article
- Published by Informa UK Limited in International Review of Psychiatry
- Vol. 2 (2), 213-227
- https://doi.org/10.3109/09540269009028285
Abstract
There are wide variations in the incidence of fatal overdoses with different antidepressants. Older tricyclic drugs such as amitriptyline and dothiepin have a higher incidence of fatality than newer atypical drugs like mianserin, whatever the age of the patient. Differences in incidence arise principally from variations in inherent toxicity and only partly from a combination of variable patient compliance and selective prescription. Inherent toxicity is mainly cardiovascular in nature, and those antidepressants with pronounced quinidine-like and atropine-like effects tend to be the most toxic in overdose. Evidence is emerging that some antidepressants, particularly selective inhibitors of 5-HT reuptake and, for different reasons, the new tricyclic lofepramine, may reduce the risk of fatal overdosage.Keywords
This publication has 53 references indexed in Scilit:
- The Toxicity of AntidepressantsThe British Journal of Psychiatry, 1989
- Suspected adverse drug reactions in elderly patients reported to the Committee on Safety of Medicines.British Journal of Clinical Pharmacology, 1988
- Fatal toxicity of antidepressant drugs in overdose.BMJ, 1987
- Binding affinities of four tricyclic antidepressive drugs to muscarinic cholinergic receptors in human parotid glandPsychopharmacology, 1986
- Value of the QRS Duration versus the Serum Drug Level in Predicting Seizures and Ventricular Arrhythmias after an Acute Overdose of Tricyclic AntidepressantsNew England Journal of Medicine, 1985
- Comparative animal studies on cardiovascular toxicity of tri- and tetracyclic antidepressants and citalopram; relation to drug plasma levelsPsychopharmacology, 1984
- Clinical efficacy and electrophysiology of imipramine for ventricular tachycardiaThe American Journal of Cardiology, 1984
- Suicide in Psychiatric In-PatientsThe British Journal of Psychiatry, 1982
- One Hundred Cases of Acute Intoxication with Mianserin HydrochloridePharmacopsychiatry, 1981
- Mortality in Depressed Patients Treated With Electroconvulsive Therapy and AntidepressantsArchives of General Psychiatry, 1976