Abstract
Using data from the US Poison Control Centers for 2000–14, Nelson and Spyker have examined morbidity and mortality after reported exposure to treatments for depression. Exposure, as noted by authors, “may involve suspected suicide attempts but also may include other reasons such as unexpected adverse events, therapeutic errors, or other forms of intentional or unintentional misuse”. 48 medications were included in the analysis. During the study period, 962 222 cases were reported to the National Poison Data System (NPDS), which were a result of exposure to a single medication. Over half of the cases were a result of suspected suicide. Amitryptilline—the tricyclic antidepressant most commonly reported to the NPDS—accounted for 145 deaths (mortality index 37·5 per 10 000 exposures, 95% CI 31·6–44·1). Of the second-generation antidepressant medications, the highest mortality indices were for venlafaxine (9·72 per 10 000 exposures, 95% CI 6·61–13·80) and bupropion (7·53 per 10 000 exposures, 5·54–10·02).
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