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Are the Prescriptions of Psychiatric Patients Who Repeatedly Attempt Suicide Distinctive? A Study Based on a Survey of Prescription Drug Overdose Patients Admitted for Emergency Medical Care

Akihisa Akahane, Kenichi Matumura, Gaku Oshikubo, Rie Kanai, Yukako Watanabe, Mamoru Tochigi, Naoki Hayashi*, Emi Ikebuchi

Objectives: Examining the pharmacotherapy of patients who have attempted suicide by overdose could be useful in developing treatment and suicide prevention plans. We surveyed the drugs taken by psychiatric prescription overdose patients who received inpatient treatment and sought to determine the characteristics of patients who repeatedly attempt suicide.

Methods: Subjects were 116 patients who attempted suicide by overdose with prescription psychiatric drugs and received inpatient treatment at the Intensive Care Unit of the Emergency and Critical Care Center of Teikyo University Hospital from August 2009 to July 2010. We retrospectively surveyed clinical characteristics, including prescriptions prior to hospitalization and psychiatric diagnosis, divided subjects into a first-admission (FA) and repeatadmission (RA) groups, and compared their clinical characteristics.

Results: All subjects were prescribed benzodiazepine-receptor agonists (BZDRAs), whereas antidepressants and antipsychotics were prescribed to 58.6% and 49.1% of subjects, respectively. Emotionally unstable personality disorder, borderline-type (EUPD-B) was found to be significantly more common in the RA group. Comparing prescriptions in the FA and RA groups indicated that the prescribed dosage and prescription rate for antipsychotics were significantly higher for RA group patients.

Conclusion: This study revealed that repeat-admission attempted suicide patients had a significantly higher rate of EUPD-B and were more frequently using antipsychotic prescription drugs. Further, in these patients, more frequent use of antipsychotics is believed to correspond to patient impulsivity. The excessive prescription of BZDRAs is a serious problem requiring urgent measures. Research on the prescriptions for overdose patients may lead to clinically significant findings and should be promoted in the future.