Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-22T19:16:54.771Z Has data issue: false hasContentIssue false
  • English
  • Français

Relationship between prescribed psychotropic medications and co-ingested alcohol in intentional self-poisonings

Published online by Cambridge University Press:  02 January 2018

Kate M. Chitty ,
Timothy Dobbins ,
Andrew H. Dawson ,
Geoffrey K. Isbister  and
Nicholas A. Buckley
Kate M. Chitty
Affiliation:
Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Sydney Medical School, University of Sydney, Sydney, New South Wales
Timothy Dobbins
Affiliation:
National Drug and Alcohol Research Centre, University of New South Wales, New South Wales
Andrew H. Dawson
Affiliation:
Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Sydney Medical School, University of Sydney, Sydney, New South Wales
Geoffrey K. Isbister
Affiliation:
Clinical Toxicology Research Group, University of Newcastle, Newcastle, New South Wales
Nicholas A. Buckley
Affiliation:
Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
Rights & Permissions [Opens in a new window]

Abstract

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.
Background

Acute alcohol consumption is a major risk factor for suicide, therefore investigating factors associated with alcohol-related self-harm warrant attention.

Aims

To investigate the influence of prescribed psychotropic medications on the odds of co-ingesting alcohol preceding or during intentional efforts to self-poison.

Method

A cross-sectional analysis of consecutive hospital presentations following intentional self-poisoning was conducted. A total of 7270 patients (4363 women) aged 18–96 were included.

Results

The odds of alcohol co-ingestion were increased in those not prescribed any medication (odds ratio (OR) = 1.27, 99% CI 1.10–1.46, P50.001) and in impulsive self-poisonings (OR= 1.39, 99% CI 1.11–1.74, P50.001). Odds were decreased in those prescribed anticonvulsants (OR = 0.69, 99% CI 0.51–0.93), antipsychotics (OR = 0.55, 99% CI 0.45–0.66) and antidepressants (OR = 0.87, 99% CI 0.77–0.99).

Conclusions

Findings indicate that being medicated for a psychiatric illness may reduce the likelihood of alcohol consumption during times of acute distress, hence perhaps may reduce the risk of intentional self-poisoning.

Type
Papers
Information
The British Journal of Psychiatry , Volume 210 , Issue 3 , March 2017 , pp. 203 - 208
Copyright
Copyright © Royal College of Psychiatrists, 2017 

Footnotes

Declaration in interest

None.

References

1 Hufford, MR. Alcohol and suicidal behavior. Clin Psychol Rev 2001; 21: 797–811.Google Scholar
2 Powell, KE, Kresnow, MJ, Mercy, JA, Potter, LB, Swann, AC, Frankowski, RF, et al. Alcohol consumption and nearly lethal suicide attempts. Suicide Life Threat Behav 2001; 32 (Suppl 1): 30–41.Google Scholar
3 Darvishi, N, Farhadi, M, Haghtalab, T, Poorolajal, J. Alcohol-related risk of suicidal ideation, suicide attempt, and completed suicide: a meta-analysis. PLoS One 2015; 10: e0126870.Google Scholar
4 Bagge, CL, Lee, HJ, Schumacher, JA, Gratz, KL, Krull, JL, Holloman, G Jr. Alcohol as an acute risk factor for recent suicide attempts: a case-crossover analysis. J Stud Alcohol Drugs 2013; 74: 552–8.Google Scholar
5 Kaplan, MS, Huguet, N, McFarland, BH, Caetano, R, Conner, KR, Giesbrecht, N, et al. Use of alcohol before suicide in the United States. Ann Epidemiol 2014; 24: 588–592.Google Scholar
6 Kaplan, MS, McFarland, BH, Huguet, N, Conner, K, Caetano, R, Giesbrecht, N, et al. Acute alcohol intoxication and suicide: a gender-stratified analysis of the National Violent Death Reporting System. Inj Prev 2013; 19: 38–43.Google Scholar
7 Medco. America's State of Mind Report. Medco Health Solutions, 2011.Google Scholar
8 Stephenson, CP, Karanges, E, McGregor, IS. Trends in the utilisation of psychotropic medications in Australia from 2000 to 2011. Aust NZ J Psychiatry 2013; 47: 74–87.Google Scholar
9 Ilyas, S, Moncrieff, J. Trends in prescriptions and costs of drugs for mental disorders in England, 1998–2010. Br J Psychiatry 2012; 200: 393–8.Google Scholar
10 Buckley, NA, Whyte, IM, Dawson, AH, Isbister, GK. A prospective cohort study of trends in self-poisoning, Newcastle, Australia, 1987–2012: plus ca change, plus c'est la meme chose. Med J Aust 2015; 202: 438–42.Google Scholar
11 Nutt, DJ. The role of the opioid system in alcohol dependence. J Psychopharmacol 2014; 28: 8–22.Google Scholar
12 Krystal, JH, Petrakis, IL, Mason, G, Trevisan, L, D'Souza, DC. N-methyl-D-aspartate glutamate receptors and alcoholism: reward, dependence, treatment, and vulnerability. Pharmacol Ther 2003; 99: 79–94.Google Scholar
13 Koob, GF, Volkow, ND. Neurocircuitry of addiction. Neuropsychopharmacology 2010; 35: 217–38.Google Scholar
14 Buckley, NA, Whyte, IM, Dawson, AH, Reith, DA. Preformatted admission charts for poisoning admissions facilitate clinical assessment and research. Ann Emer Med 1999; 34: 476–82.Google Scholar
15 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). APA, 1987.Google Scholar
16 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder (4th edn) (DSM-IV). APA, 1994.Google Scholar
17 Carter, G, Reith, DM, Whyte, IM, McPherson, M. Repeated self-poisoning: increasing severity of self-harm as a predictor of subsequent suicide. Br J Psychiatry 2005; 186: 253–7.Google Scholar
18 Carter, G, Reith, DM, Whyte, IM, McPherson, M. Non-suicidal deaths following hospital-treated self-poisoning. Aust NZ J Psychiatry 2005; 39: 101–7.10.1080/j.1440-1614.2005.01515.xGoogle Scholar
19 MIMS. Central nervous system. In MIMS Annual: 110–72. UBM Medica Australia, 2009.Google Scholar
20 Mesholam-Gately, RI, Gibson, LE, Seidman, LJ, Green, AI. Schizophrenia and co-occurring substance use disorder: reward, olfaction and clozapine. Schizophr Res 2014; 155: 45–51.Google Scholar
21 Kapur, S, Seeman, P. Does fast dissociation from the dopamine d(2) receptor explain the action of atypical antipsychotics?: a new hypothesis. Am J Psychiatry 2001; 158: 360–9.Google Scholar
22 Gillman, PK. Tricyclic antidepressant pharmacology and therapeutic drug interactions updated. Br J Pharmacol 2007; 151: 737–48.Google Scholar
23 McManus, P, Mant, A, Mitchell, PB, Montgomery, WS, Marley, J, Auland, ME. Recent trends in the use of antidepressant drugs in Australia, 1990–1998. Med J Aust 2000; 173: 458–61.Google Scholar
24 Olfson, M, Marcus, SC. National patterns in antidepressant medication treatment. Arch Gen Psychiatry 2009; 66: 848–56.Google Scholar
25 Roxburgh, A, Ritter, A, Slade, T, Burns, L. Trends in Drug Use and Related Harms in Australia, 2001 to 2013. National Drug and Alcohol Research Centre, University of New South Wales, 2013.Google Scholar
26 Dvorak, RD, Lamis, DA, Malone, PS. Alcohol use, depressive symptoms, and impulsivity as risk factors for suicide proneness among college students. J Affect Dis 2013; 149: 326–34.Google Scholar
27 Rahn, KA, Cao, YJ, Hendrix, CW, Kaplin, AI. The role of 5-HT1A receptors in mediating acute negative effects of antidepressants: implications in pediatric depression. Transl Psychiatry 2015; 5: e563.Google Scholar
28 Food and Drug Administration (FDA). FDA Proposes New Warnings About Suicidal Thinking, Behavior in Young Adults Who Take Antidepressant Medications. FDA, 2007 (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2007/ucm108905.htm).Google Scholar
29 Silva, H, Iturra, P, Solari, A, Villaroel, J, Jerez, S, Jiménez, M, et al. Fluoxetine response in impulsive-aggressive behavior and serotonin transporter polymorphism in personality disorder. Psychiatr Genet 2010; 20: 25–30.Google Scholar
30 Regier, DA, Farmer, ME, Rae, DS, Locke, BZ, Keith, SJ, Judd, LL, et al. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA 1990; 264: 2511–8.Google Scholar
31 Pettinati, HM, O'Brien, CP, Dundon, WD. Current status of co-occurring mood and substance use disorders: a new therapeutic target. Am J Psychiatry 2013; 170: 23–30.Google Scholar
32 Chitty, KM, Lagopoulos, J, Hickie, IB, Hermens, DF. Alcohol use in bipolar disorder: a neurobiological model to help predict susceptibility, select treatments and attenuate cortical insult. Neurosci Biobehav Rev 2015; 56: 193–206.Google Scholar
33 Iovieno, N, Tedeschini, E, Bentley, KH, Evins, AE, Papakostas, GI. Antidepressants for major depressive disorder and dysthymic disorder in patients with comorbid alcohol use disorders: a meta-analysis of placebo-controlled randomized trials. J Clin Psychiatry 2011; 72: 1144–51.Google Scholar
34 Kishi, T, Sevy, S, Chekuri, R, Correll, CU. Antipsychotics for primary alcohol dependence: a systematic review and meta-analysis of placebo-controlled trials. J Clin Psychiatry 2013; 74: e642–54.Google Scholar
35 Martin, G, Swannell, SV, Hazell, PL, Harrison, JE, Taylor, AW. Self-injury in Australia: a community survey. Med J Aust 2010; 193: 506–10.Google Scholar
Supplementary material: PDF

Chitty et al. supplementary material

Supplementary Material

Download Chitty et al. supplementary material(PDF)
PDF 55.2 KB
Submit a response

eLetters

No eLetters have been published for this article.