ArticleThe British journal of psychiatry : the journal of mental science2010
Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose.
Article in The British journal of psychiatry : the journal of mental science, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 4 syntheses or guidelines pooled it, 192 citations in OpenAlex.
- Antidepressants and Risk of Sudden Cardiac Death: A Network Meta-Analysis and Systematic Review.Medical sciences (Basel, Switzerland) · 2021Pooled it
- Interventions for self-harm in children and adolescents.The Cochrane database of systematic reviews · 2021Pooled it
- Pharmacological interventions for self-harm in adults.The Cochrane database of systematic reviews · 2021Pooled it
- Pharmacological interventions for self-harm in adults.The Cochrane database of systematic reviews · 2015Pooled it
- Antidepressant metabolite concentrations and metabolite-to-parent drug ratios in postmortem femoral blood.Journal of analytical toxicology · 2026Article
- Psychological Adverse Events and Associated Safety Profiles of Doxepin: A Pharmacovigilance Study Using VigiBase.Journal of Korean medical science · 2025Article
- The relative toxicity of medicines detected after poisoning suicide deaths in Australia, 2013-19: a data linkage case series study.The Medical journal of Australia · 2025Article
- Article
- Epidemiological and Clinical Characteristics of Pediatric Acute Drug Intoxications: A Retrospective Analysis.Children (Basel, Switzerland) · 2024Article
- Analytically Confirmed Intentional Overdose of the Antidepressant Vortioxetine.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2024Article
- Involvement of propranolol in suicides: cross-sectional study using coroner-reported data.BJPsych open · 2024Article
- Association between Prescribing and Intoxication Rates for Selected Psychotropic Drugs: A Longitudinal Observational Study.Pharmaceuticals (Basel, Switzerland) · 2024Article
- SSRIs in the Treatment of Depression: A Pharmacological CUL-DE-SAC?Current topics in behavioral neurosciences · 2024Review
- The cardiovascular safety of tricyclic antidepressants in overdose and in clinical use.Therapeutic advances in psychopharmacology · 2024Review
- Article
- Fatal concentrations of antidepressant and antipsychotic drugs in postmortem femoral blood.Journal of analytical toxicology · 2023Article
- Sex Differences in Health Conditions Associated with Sexual Assault in a Large Hospital Population.Complex psychiatry · 2023Article
- Antidepressant use and risk of self-harm among people aged 40 years or older: A population-based cohort and self-controlled case series study.The Lancet regional health. Western Pacific · 2022Article
- The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries.European archives of psychiatry and clinical neuroscience · 2022Article
- Characterizing stimulant overdose: A qualitative study on perceptions and experiences of "overamping".The International journal on drug policy · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundSelf-poisoning is a common method of suicide and often involves ingestion of antidepressants. Information on the relative toxicity of antidepressants is therefore extremely important.
aimsTo assess the relative toxicity of specific tricyclic antidepressants (TCAs), a serotonin and noradrenaline reuptake inhibitor (SNRI), a noradrenergic and specific serotonergic antidepressant (NaSSA), and selective serotonin reuptake inhibitors (SSRIs).
methodObservational study of prescriptions (UK), poisoning deaths involving single antidepressants receiving coroners' verdicts of suicide or undetermined intent (England and Wales) and non-fatal self-poisoning episodes presenting to six general hospitals (in Oxford, Manchester and Derby) between 2000 and 2006. Calculation of fatal toxicity index based on ratio of rates of deaths to prescriptions, and case fatality based on ratio of rates of deaths to non-fatal self-poisonings.
resultsFatal toxicity and case fatality indices provided very similar results (rho for relative ranking of indices 0.99). Case fatality rate ratios showed greater toxicity for TCAs (13.8, 95% CI 13.0-14.7) than the SNRI venlafaxine (2.5, 95% CI 2.0-3.1) and the NaSSA mirtazapine (1.9, 95% CI 1.1-2.9), both of which had greater toxicity than the SSRIs (0.5, 95% CI 0.4-0.7). Within the TCAs, compared with amitriptyline both dosulepin (relative toxicity index 2.7) and doxepin (2.6) were more toxic. Within the SSRIs, citalopram had a higher case fatality than the other SSRIs (1.1, 95% CI 0.8-1.4 v. 0.3, 95% CI 0.2-0.4).
conclusionsThere are wide differences in toxicity not only between classes of antidepressants, but also within classes. The findings are relevant to prescribing decisions, especially in individuals at risk, and to regulatory policy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.