Suicide attempts with amitriptyline in adults: a prospective, demographic, clinical study

Authors: ŞAHİN ASLAN, MÜCAHİT EMET, ZEYNEP ÇAKIR, AYHAN AKÖZ, SULTAN TUNA AKGÖL GÜR

Abstract: There are several studies on tricyclic antidepressant (TCA) intoxication in the literature; however, there is no specific study on amitriptyline, a specific TCA, intoxication. Materials and methods: Forty adult patients who had been admitted to the emergency department due to suicide attempts with amitriptyline were included. Medical and social histories of the patients were obtained. The estimated amount of amitriptyline ingested was determined. The psychiatric support and psychiatric diagnosis were all recorded. All patients were contacted by phone 6 months later. Results: Main reason of suicidal attempt was family problems. The stated amount of ingested amitriptyline by the patient or parents was between 60 mg and 1250 mg. Mean cost of diagnosis and treatment were US$ 87.9 ± 83.5 and US$ 290.5 ± 164.8, respectively. Somnolence was the main complaint. Sinus tachycardia and hypocalcaemia were the most common findings. Seven and a half percent of the patients had a GCS score under 8. There was a significant negative correlation between mean arterial pressure and the estimated ingested amitriptyline dose. After discharge, 52.5% of the patients visited the psychiatry outpatient clinics. There was only 1 patient with recurrent suicidal attempt. Conclusion: Amitriptyline was usually abused by young females in our region. Drowsiness, dizziness, and urinary retention were the most common clinical features. Family conflicts and communication problems were the most cited reasons of suicide attempts.

Keywords: Tricyclic antidepressant, amitriptyline, suicide attempt, psychiatry

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