Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-14T16:37:30.041Z Has data issue: false hasContentIssue false
  • English
  • Français

Toxicity of newer versus older antidepressants

Published online by Cambridge University Press:  02 January 2018

John A. Henry
Rights & Permissions [Opens in a new window]

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Of all the controversies over the different medications used in psychiatry, there is probably least dispute about the effectiveness of antidepressants in controlling depressive illness. However, the choice of which antidepressant to use is bedevilled by the spectre of potential toxicity from adverse effects, interactions and overdose. The unwanted effects may vary from mild and tolerable to potentially lethal. At one time it was relatively easy to become familiar with the problems surrounding the original two main groups of antidepressants – the tricyclic antidepressants (TCAs) and the monoamine oxidase inhibitors (MAOIs). Recent years have seen the introduction of a number of newer drugs, with a wide range of chemical structures and differing pharmacological activities. They also have a new spectrum of adverse effects and interactions. It is worth reviewing the major differences between old and new antidepressants, and to identify the areas in which clinical caution must be exercised in order to avoid pitfalls and maximise clinical benefit.

Type
Research Article
Information
Advances in Psychiatric Treatment , Volume 3 , Issue 1 , January 1997 , pp. 41 - 45
Copyright
Copyright © The Royal College of Psychiatrists 1997 

References

Anderson, I. (1997) Lessons to be learnt from meta-analyses of newer versus older antidepressants. Advances in Psychiatric Treatment, 3, 57–62.Google Scholar
Brown, T. M., Skop, B. P. & Mareth, T. R. (1996) Pathophysiology and management of the serotonin syndrome. Annals of Pharmacotherapy, 30, 529–533.Google Scholar
Donoghue, J. M. (1994) The prescribing of antidepressants in general practice: The use of PACT data. Postgraduate Medical Journal, 70 (suppl. 2), S23–S24.Google Scholar
Freemantle, N., House, A., Song, F. et al (1994) Prescribing selective serotonin reuptake inhibitors as strategy for prevention of suicide. British Medical Journal, 309, 250–253.Google Scholar
Department of Health (1994) Health of the Nation: Suicide Prevention – The Challenge Confronted. London: Her Majesty's Stationery Office.Google Scholar
Henry, J. A., Alexander, C. A. & Sener, E. K. (1995). Relative mortality from overdose of antidepressants. British Medical Journal, 310, 221–224.Google Scholar
Johnson, D. A. W. (1986) Non-compliance with antidepressant therapy: An underestimated problem. Internal Medicine, suppl. 11, 14–17.Google Scholar
Kelvin, A. S. & Hakansson, S. (1989) Comparative acute toxicity of paroxetine and other antidepressants. Acta Psychiatrica Scandinavica, 80, 31–33.CrossRefGoogle Scholar
Meredith, T. (1995) Epidemiology of poisoning. Medicine, 23, 1–3.Google Scholar
Molcho, A. & Stanley, M. (1992) Antidepressants and suicide risk: Issues of chemical and behavioural toxicity. Journal of Clinical Pharmacology, 12 (suppl. 2), S13–S18.Google Scholar
Öström, M., Eriksson, A., Thorson, J. et al (1996) Fatal overdose with citalopram. Lancet, 348, 339–340.Google Scholar
Smith, T. (1995) Differences between general practices in hospital admission rates for self-inflicted injury and self-poisoning: Influence of socioeconomic factors. British Journal of General Practice, 45, 458–462.Google Scholar
Sternbach, H. (1991) The serotonin syndrome. American Journal of Psychiatry, 148, 705–713.Google ScholarPubMed
Thompson, C. & Thompson, C. M. (1989) The prescribing of antidepressants in general practice. II: A placebo-controlled trial of low-dose dothiepin. Human Psychopharmacology, 4, 191–204.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.