ANTIDEPRESSANT DEATHS BY OVERDOSE

Objective: To determine the prevalence of antidepressant deaths in Sou th Australia, the relative frequency of each antidepressant used and d emographic data of those who died. Method: This was a retrospective, c ase note study of ail cases where death was caused by lethal levels of antidepressants in South Australia for the period from 1986 to 1990, The study occurred at the South Australian coroner's office, Subjects were selected from toxicology data, where serum or liver levels of one or more antidepressant were in the lethal range. Results: Seventy-one cases were identified and information was obtained on 68 of these cas es from the coroner's files, Amitriptyline, Doxepin and Dothiepin acco unted for the majority of antidepressant deaths, Women were 2.5 times more likely to use antidepressants to suicide than men, At least 63% h ad a known psychiatric illness and 45% had previously attempted suicid e. Conclusions: The older tricyclic antidepressants are a significant cause of suicide, It is recommended that the newer antidepressants, wh ich are as efficacious yet safer in overdose, be prescribed in prefere nce to the older tricyclic antidepressants, as the first line of treat ment in newly diagnosed depressed outpatients.