OP27 A national case fatality study of drugs taken in intentional overdose

Daly, CD; Griffin, E; Corcoran, P; Webb, RW; Ashcroft, DA; Perry, IJ; Arensman, E

doi:10.1136/jech-2019-ssmabstracts.27

Cited by 2 publications

(2 citation statements)

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“…12,13 For this and other reasons, the medications of this class, in particular amitriptyline, are notoriously known as one of the most common agents of an intentional drug overdose, resulting in 395 fatal cases in England and Wales over 2000−2006 14 and 784 fatal cases over 2007−2014, with a fatality risk close to 5%. 15 The use of sustained-release formulations delays the time to reach toxic concentration and, therefore, prolongs the period for the first aid to be effective. Amitriptyline (AMT) (Scheme 1) is a tricyclic antidepressant that was long considered a standard medication for depression treatment and is still frequently used as a secondline treatment of mental disorders, 1 including major depressive disorder, insomnia, obsessive-compulsive disorder, panic disorder, attention-deficit/hyperactivity disorder, bulimia, etc.…”

Section: Introductionmentioning

confidence: 99%

Multicomponent Crystals of Amitriptyline as Potential Controlled-Release Systems: Synthesis, Crystal Packing Analysis, and Dissolution Study

Voronin

Ramazanova

Surov

et al. 2023

Crystal Growth & Design

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In the present work, for the first time, a crystal engineering approach was systematically applied to produce novel crystalline forms of the tricyclic antidepressant amitriptyline (AMT) with modified aqueous dissolution kinetics. Six novel multicomponent crystals, including three salts with dicarboxylic acid counterions, two salt cocrystals, and a salt hydrate, were obtained and structurally characterized by single-crystal X-ray diffraction analysis. The structural analysis revealed that all of the investigated crystals contain two-dimensional (2D) bilayers of AMT cations separated by organic counterions; however, the packing arrangements of AMT cations within the bilayers were found to differ significantly. The structure-directing role of 2D bilayers of AMT was discussed based on insights from periodic density functional theory (DFT) computations. The dissolution performance of the obtained solid forms was studied in the FaSSGF buffer solution under sink conditions and compared to that of the commercial form AMT-HCl. The effect of the salt formation on the AMT release profile was assessed using five different dissolution models. The potential of the AMT maleate and AMT oxalate salts as a basis for the design of controlled-release forms was discussed.

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Section: Introductionmentioning

confidence: 99%

Multicomponent Crystals of Amitriptyline as Potential Controlled-Release Systems: Synthesis, Crystal Packing Analysis, and Dissolution Study

Voronin

Ramazanova

Surov

et al. 2023

Crystal Growth & Design

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“…completed and attempted suicide) and increased use of higher-lethality methods (Wang et al 2020). Furthermore, while overdose is viewed as a low-lethality method, and women are more likely to use this method than men (Griffin et al 2019), a national case fatality study of intentional drug overdose demonstrated that male sex is associated with a fatal outcome (Daly et al 2020). This is consistent with the well-documented suicide paradox: suicide attempt rates are higher among females, whereas lethality is higher among males (Stone & Crosby, 2014).…”

Section: Introductionmentioning

confidence: 99%

Attempted suicide: does lethality matter?

Doherty

Moore

Cobercoran

et al. 2021

Ir. j. psychol. Med.

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Objectives: To investigate whether high-lethality suicide attempters align to the demographic and clinical features observed in completed suicide in the national and international literature, and whether low-lethality attempters more closely align with the clinical profile of non-attempter ideators. Methods: A retrospective chart review of adult suicide ideators and attempters presenting to an urban tertiary care hospital was performed. Suicide ideators (n = 50) and attempters (n = 50) were coded for variables including demographics and clinical characteristics (e.g. psychiatric diagnosis and previous suicide attempt). Method and lethality of suicide attempt were coded using the medical Lethality Rating Scale. Results: High-lethality attempters were more likely to be younger in age than low-lethality attempters (p = 0.026) and ideators (p = 0.041). The lethality scores of suicide attempts were significantly inversely correlated with age (p = 0.017). Conclusions: Our study adds to the small but increasing body of literature investigating the characteristics of high-lethality suicide attempters and suggests younger adult age is a risk factor for a high-lethality attempt. Further understanding of this unique group would be aided by widespread agreement on the definition of a high-lethality suicide attempt and longitudinal studies of this cohort.

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OP27 A national case fatality study of drugs taken in intentional overdose

Cited by 2 publications

References 0 publications

Multicomponent Crystals of Amitriptyline as Potential Controlled-Release Systems: Synthesis, Crystal Packing Analysis, and Dissolution Study

Multicomponent Crystals of Amitriptyline as Potential Controlled-Release Systems: Synthesis, Crystal Packing Analysis, and Dissolution Study

Attempted suicide: does lethality matter?

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