Clinical characteristics of patients with psychotropic drug overdose admitted to the emergency department

Ookura Ryusuke, Mino Koichi, Ogata Masaaki

doi:10.3893/jjaam.19.901

To clarify the clinical characteristics of patients with psychotropic drug overdose, we retrospectively evaluated 194 patients (273 visits) with psychotropic drug overdose who consulted to the emergency room of Kobe City Medical Center West Hospital from January 2004 to December 2006. Among the patients, 41 patients consulted more than twice during the period. A hundred and fifty-nine patients (234 visits) were female. Females of 20-39 years old formed the largest demographic group. A significant number of patients overdosed from 3 pm to 2 am. The mean time between the commitment of the drug overdose and the arrival at the emergency room was about 4 hours. The psychotropic drugs taken for overdose were prescribed by psychiatrists in 201 cases and by non-psychiatrists in 28 cases, and were bought over the counter for insomnia in 12 cases. Benzodiazepines were present in a majority of the cases. Concerning the psychiatric diagnoses for the prescription, F4 (neurotic, stress-related and somatoform disorders) and F3 (mood disorders) in the diagnostic criteria of International Classification of Disease 10 were most frequently confirmed. Blood tests were used frequently for the cases, while the use of ECG or chest X-rays was limited. Gastric lavage, activated charcoal and laxative were used respectively in 28.9%, 22.7% and 16.8% of the cases. A hundred and twenty-six cases (46.2%) were hospitalized. Patients brought by ambulance were hospitalized at higher rate. Simultaneous use of alcohol as well as the idea of suicide raised the rate of hospitalization. The median length of stay in hospital was 2 days (range; 1 to 60 days). Ninety-four cases (34.3%) were consulted by the attending psychiatrists. No patient died from overdose. One case was treated for multiple organ failure after cardiopulmonary resuscitation, and 12 cases were treated for pneumonia. Twenty-one cases (7.7%) re-consulted the emergency department for overdose within a week after they had returned home. Thus, the results of the study showed the characteristics of patients who consulted the emergency department for psychotropic drug overdose, and also addressed the problems in the way of how they were treated in the emergency room of the regional hospital.

Clinical characteristics of patients with psychotropic drug overdose admitted to the emergency department

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