Toxicology Investigation

Journal of Medical Toxicology

, Volume 6, Issue 2, pp 116-121

A Comparison of Venlafaxine and SSRIs in Deliberate Self-poisoning

  • Agnes N. ChanAffiliated withConsultation- Liaison Psychiatry, Royal Prince Alfred HospitalPsychiatry, University of Sydney Email author 
  • , Naren GunjaAffiliated withWestmead HospitalNSW Poisons Information Centre, The Children’s HospitalEmergency Medicine, University of Sydney
  • , Christopher J. RyanAffiliated withWestmead HospitalPsychological Medicine, University of Sydney

Abstract

To compare the clinical features of deliberate self-poisoning with venlafaxine and selective serotonin reuptake inhibitors (SSRIs) presenting to the emergency department of an Australian tertiary referral hospital. A retrospective cohort study comparing all 36 patients who presented with venlafaxine self-poisoning with 44 randomly selected patients with SSRI self-poisoning between 1997 and 2006. Patients who had overdosed on venlafaxine were older (mean age 37.4 versus 28.8 years, p ≤ 0.001) and generally exhibited a higher degree of suicidal intent (p ≤ 0.017). Median venlafaxine dose taken was 35 defined daily doses (DDDs) compared with SSRIs 19.4 DDDs. Those who ingested venlafaxine were more likely to become confused (25% versus 0%; p = 0) and have mydriasis (19.4% versus 2%; p ≤ 0.02), than those who took SSRIs. One patient from the venlafaxine group died. Compared with SSRI self-poisoners, patients who deliberately ingested venlafaxine were more likely to exhibit serious suicide intent. They were also more likely to be older, take a higher DDD of the drug, and have confusion and mydriasis. This has implications for management of severely depressed and suicidal patients.

Keywords

Venlafaxine Serotonin reuptake inhibitors Overdose Self-poisoning Suicide