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Citation
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Kantarci MN, Kandemir E, Balkay M, Berber G, Demirel O, Emul M, Tutkun H. Klin. Psikofarmakol. Bül. 2013; 23(2): 155-161. |
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Abstract
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OBJECTIVE: The goal of this study was to determine the drugs of choice, the preferred routes of administration and the time to death among depressive disorder patients who have committed suicide by drug overdose.
METHODS: Thirty-one patients were included in this study, 13 females and 18 males, who had committed suicide by drug overdose, had a major depression, and had active drug substances detected in post-mortem samples. The drugs detected after autopsy were categorized into 3 groups: "containing only anti-depressant", "containing other than antidepressant" and "containing a mixture of anti-depressant(s) and drug(s) of another ATC class". According to the results of the autopsies, 35 kinds of drugs were found in post mortem samples of blood, urine and/or tissues. The 35 kinds of drugs used for suicide were found to be used either solely or as a combination of 2 to 6 different drugs. Only 4 cases out of 31 had cocktails of 4 types or more. Thus, we categorized the combinations of drugs during the statistical evaluation in three classes as "single", "duo" and "three or more (≥ 3)".
RESULTS: In both sexes, the number of suicides was higher in the "containing other than anti-depressant" group. However, there was no statistically significant difference between the genders according to drug groups. The "containing other than anti-depressant" group of drugs was preferred as a "single" or "duo" combination. The "containing a mixture of anti-depressant(s) and drug(s) of another ATC class " group was preferred as a "three or more ≥ 3" combination. There was a statistically significant difference between the drug combinations in reference to drug groups (p=0.05). Sixteen patients were found dead on the same day as the overdose and 15 patients died after intensive care treatment. Among the patients who committed suicide by using a member of the "containing only antidepressant" drug group, the number of patients who were found dead on the same day as the overdose was more than the number of patients who died after intensive care treatment. However, there is no statistically significant difference between drug groups in reference to the time to death.
CONCLUSION: The most common or most lethal drugs that cause intoxication should be stringently controlled. When the effects of therapeutic doses are explained during informed consent, the patients should be informed about the consequences when drugs are taken concomitantly. Patients with a depression diagnosis can be dispensed medications in counted unit doses, instead of the whole box. In this case, the remaining part in the box should be kept in a safe place with restricted access for the patient, if necessary. Patients with diabetes should also be closely observed and evaluated for depression.
Language: en |