Merely prescribing safer-in-overdose antidepressants is unlikely to reduce the overall morbidity from DSH.

Auranofin, 2,3,4,6-tetra-O-acetyl-1-thio-beta-D-glucopyranosato-S-(triethy lphosphine)- gold(I), an experimental antiarthritis pharmaceutical, metabolized in contact with hamster or rat gut wall to yield the deacetylated form of the drug. This product, 1-thio-beta-D-glucopyranosato-S-(triethylphosphine)gold(I), passed through hamster or rat intestinal wall in an everted gut experiment. The metabolite was separated by high-performance liquid chromatography and characterized by retention time, chemical reactivity to yield a known product, and comparison to a synthetic sample of the metabolite.

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It is generally accepted that the risk of fatality after overdose with tricyclic antidepressants (TCAs) is greater than after overdose with nontricyclic antidepressants (particularly selective serotonin reuptake inhibitors [SSRIs]). This has provided one of the most powerful arguments for the use of SSRIs in preference to TCAs in depressed patients. In England and Wales, however, overdose involving antidepressants accounts for the minority (6%) of suicides, the majority being a result of a violent method (38%), overdose or ingestion of any toxic substance other than an antidepressant (25%), or gassing, mostly by curbon monoxide inhalation from motor vehicle exhausts (18%).Using the Geneml Practice Research Database (GPRD), it has been possible to estimate the proportion of all-methodsuicides which occur following the prescription of TCAs or an SSRI. After adjustment for confounding factors, the overall occurrence of suicide by any method was not statistically significantly different between patients treated with either group of drugs. Thus, replacement of TCAs by SSRIs as a strategy to reduce the overall suicide rate is unlikely to succeed.