Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions
Depression Drug Risks Have Risen Dramatically
Am J Psychiatry; ePub 2017 Jan 31; Nelson, et al
Serious outcomes after overdose or non-intentional exposures to medications used to treat depression have risen dramatically over the past 15 years, and a recent study suggests that the morbidity and mortality risks vary substantially among these medications. These differences become important when selecting treatments for patients with depression, especially those at increased risk for suicide. The National Poison Data System, which receives exposure reports from regional poison centers serving the US, Puerto Rico, and the District of Columbia, was queried for single drug exposures in individuals aged ≥12 years during the period from 2000 to 2014. Medications included were antidepressants, atypical antipsychotics, anticonvulsants, lithium, and other medications used in the treatment of depression. Researchers found:
- During this 15-year period, there were 962,222 single substance exposures to the 48 medications studied.
- Serious outcomes rose 2.26-fold and in linear fashion over the 15 years.
- While tricyclic and monoamine oxidase inhibitor medications were associated with high morbidity and mortality, several newer agents also appeared hazardous.
Nelson JC, Spyker DA. Morbidity and mortality associated with medications used in the treatment of depression: An analysis of cases reported to U.S. Poison Control Centers, 2000–2014. [Published online ahead of print January 31, 2017]. J Am Psychiatry. doi:10.1176/appi.ajp.2016.16050523.