Zeynep ÇAKIR, Şahin ASLAN, Ahmet AKÖZ, Sultan Tuna AKGÖL GÜR, Mücahit EMET

Yetişkinlerde amitriptilinle intihar girişimleri: İleriye dönük, demografik ve klinik bir çalışma

Amaç: Literatürde trisiklik antidepresan (TCA) zehirlenmeleriyle ilgili pek çok yayın vardır, fakat spesifik bir TCA olanamitriptilin zehirlenmesiyle ilgili özel bir çalışma yoktur.Yöntem ve gereç: Amitriptilin zehirlenmesi yoluyla intihar girişiminde bulunan ve acil servise başvuran 40 yetişkinhasta çalışmaya dahil edildi. Hastaların tıbbi ve sosyal öyküleri alındı. Psikiyatrik tanı ve tedavileri kaydedildi. Tümhastalar 6 ay sonra telefonla bağlantı kurularak yeniden değerlendirildi.Bulgular: İntihar girişiminde temel neden aile problemleriydi. Ağızdan alındığı belirtilen amitriptilin dozu 60-1250 mg(ortalama: 293,6 ± 233,5 mg/doz) idi. Ortalama tanı ve tedavi maliyeti sırasıyla 87,9 ± 83,5 (dağılım: 64,9-147,9) ve 290,5± 164,8 (dağılım: 69,0-856,7) Amerikan dolarıydı. Uyku hali temel yakınmaydı. Sinüs taşikardisi ve hipokalsemi en sıkgörülen bulgulardı. Hastaların % 7,5’inde GKS 8 in altındaydı. Hastaların ortalama arteriyal kan basınçları ile tahminialınan amitriptilin dozları arasında anlamlı negatif ilişki mevcuttu. Taburculuktan sonra, hastaların % 52,5’i psikiyatripolikliniğine başvurduklarını bildirdi. Tekrar intihar girişiminde bulunan yalnızca bir hasta vardı.Sonuç: Bölgemizde amitriptilin sıklıkla genç bayanlar tarafından kötüye kullanılmaktadır. Uyuşukluk, sersemlik ve idrarretansiyonu en sık klinik bulgulardı. Belirtilen en sık intihar nedenleri aile içi çatışmalar ve iletişim problemleriydi.

Anahtar Kelimeler:

Trisiklik antidepresan, amitriptilin, intihar girişimi, psikiyatri

Suicide attempts with amitriptyline in adults: a prospective, demographic, clinical study

There are several studies on tricyclic antidepressant (TCA) intoxication in the literature; however, there is no specific study on amitriptyline, a specific TCA, intoxication. Materials and methods: Forty adult patients who had been admitted to the emergency department due to suicide attempts with amitriptyline were included. Medical and social histories of the patients were obtained. The estimated amount of amitriptyline ingested was determined. The psychiatric support and psychiatric diagnosis were all recorded. All patients were contacted by phone 6 months later. Results: Main reason of suicidal attempt was family problems. The stated amount of ingested amitriptyline by the patient or parents was between 60 mg and 1250 mg. Mean cost of diagnosis and treatment were US 87.9 ± 83.5 and US 290.5 ± 164.8, respectively. Somnolence was the main complaint. Sinus tachycardia and hypocalcaemia were the most common findings. Seven and a half percent of the patients had a GCS score under 8. There was a significant negative correlation between mean arterial pressure and the estimated ingested amitriptyline dose. After discharge, 52.5% of the patients visited the psychiatry outpatient clinics. There was only 1 patient with recurrent suicidal attempt. Conclusion: Amitriptyline was usually abused by young females in our region. Drowsiness, dizziness, and urinary retention were the most common clinical features. Family conflicts and communication problems were the most cited reasons of suicide attempts.

Keywords:

amitriptyline, suicide attempt, psychiatry, Tricyclic antidepressant,

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