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Abstract
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OBJECTIVE: This study provides three prevalence-based metrics of potential harm, the fatal toxicity index (FTI), serious morbidity index (SMI) and healthcare utilization index (HUI) for fourteen of the most prescribed antidepressants in the US.
METHOD: For the years 2013-2020, adverse events for single drug exposures were obtained from the National Poison Data System. Prescription estimates were taken from the Agency for Healthcare Research and Quality's Medical Expenditure Survey. 95% confidence intervals were calculated using a Poisson distribution. Chi-square testing was used where significance was not clear.
RESULTS: SSRIs and SNRIs had the lowest overall indices (FTI 0.02-0.26). Bupropion's FTI (0.27-0.43) was not statistically significantly different from that of imipramine (FTI 0-1.3, p = .62) or nortriptyline (FTI 0.25-0.78, p = .22), though its SMI and HUI were significantly greater. There was a statistically significant difference in all indices between TCAs (p < .0047). The difference between the FTI of all SSRIs did not remain significant after correction (p = .045).
CONCLUSION: SSRIs and SNRIs are safer than alternative agents on all measures. Bupropion exposure was as likely to cause mortality, and more likely to cause morbidity or require treatment in a healthcare facility, than TCAs nortriptyline and imipramine.
Language: en |