Antidepressant poisonings reported to the Drug and Poison Information Center in Izmir, Turkey

Background: Poisonings concerning antidepressants that were reported to Drug and Poison Information Center (DPIC), in Izmirbetween 1993 and 2004 was analyzed in our retrospective study. Methods: Age, sex, antidepressant type, route and reason forthe exposure, clinical effects and outcome of the poisoned patients were recorded on standart data forms, then entered into acomputerized database program. The severity of clinical manifestations were graded and assessed according to the EAPCCT/IPCS Poisoning Severity Score. Statistical analysis was performed by using the chi-squre test. Result: The DPIC recorded 55,962 calls concerning poisoning, 5,516 (9.9%) of them with 5857 antidepressant agents were antidepressant poisonings. Female/male ratio was 2.7. The most involved antidepressants were tricyclics (62.4%, 45% of them amitripyline) and selective serotoninre-uptake inhibitors (23.2%). The incidence of concomitant drug or alcohol intake with an antidepressant drug was 6.2%. Whileaccidental poisonings were the most common cause of poisoning between 0–6 years (92.1%), rate of intentional poisoningswere higher in 19–29 age group of adults (p<0.05) and 13–18 age group of children (p<0.0001). At the time of the telephoneinquiry, there were no symptoms in 80.6% of patients. Clinical effects were graded as mild (11.7%), moderate (2.6%) or severe(5.1%). Observation alone was recommended in 23.9 of cases. Gastric lavage (0.8%), activated charcoal (31.2%), gastric lavagewith activated charcoal (30.6%) were other recommended gastrointestinal decontamination attempts. Outcome results of most ofthe patients were not reached (85.7%). According to our results, only one 2.5 year old child died from amitriptylineingestion. Conclusion: Intentional poisonings with tricyclic antidepressant ingestions are common cause of antidepressantpoisonings reported to our DPIC. Although our center helps the appropriate management of antidepressant ingestions, spontanreporting system limits the records of all antidepressant poisonings with their outcome results.