Psychopharmacologic Management of Suicidality in Personality Disorders

To review the evidence for the efficacy of pharmacotherapy and other biological treatments in suicidality associated with personality disorders, chiefly borderline personality disorder. Systematic review of the literature. Studies evaluating treatment of suicidality in personality disorders are absent. However, several studies examine the efficacy of pharmacotherapy for core symptom clusters that are closely associated with […]

Suicide Among Drug Addicts in the UK

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Pharmacotherapy of Suicidal Behavior in Bipolar Disorder

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Benzodiazepine Fatal Poisonings

In this letter to the editor, the authors comment on an article by Serfaty & Masterton on the role of benzodiazepines in fatal poisonings. They discuss a 1990 survey conducted in Switzerland on this topic. It was found that benzodiazepines comprised 3% of all drugs taken in attempted suicide, & 8% of drugs taken in […]

Association Between Epilepsy and Attempted Suicide

In a two-year study of patients admitted to hospital after deliberate self-poisoning or self-injury, a fivefold excess of patients with epilepsy was found compared with general population prevalence rates. Males with epilepsy were particularly over-represented. Patients with epilepsy were prone to make repeat attempts. Anticonvulsants, particularly barbiturates, were used in most cases of self-poisoning. (14 […]

Poisonings in Laboratory Personnel and Health Care Professionals

A case report of an unresponsive chemist presenting to the emergency department is presented; in retrospect, the patient was discovered to have intentionally ingested cyanide. A literature review regarding ingestions in laboratory & health care personnel revealed 5 common points: barbiturates, carbon monoxide, cyanide, azides & methemoglobin-inducing chemicals. Key diagnostic findings, in the absence of […]

MMPI Characteristics of Drug Abusers With and Without Histories of Suicide Attempts

This study found that, compared to drug addicts without histories of suicide attempts, drug addicts who had attempted suicide were characterized by higher levels of maladjustment- particularly in the areas of depression, feelings of alienation, & use of projection & externalization- & were emotionally withdrawn. The results of the MMPI, as well as statistics on […]

Availability of Psychotropic Drugs and Suicidal Self-Poisoning Mortality in Belgium From 1971-1984

Trends in completed suicide in Belgium for 1971-1984 in relation to data about psychotropic drug sales were studied. Mortality rose sharply between 1973-1980 & then decreased slightly. Increasing risk of suicide was not related to psychotropic drug sales but to an increase in the severity of attempts until 1980. Although barbiturate sales decreased these drugs […]

Self-poisoning

This article expresses concern for the steep rise in barbituates consumption, which may have lead to a dramatic increase in suicide as well. An article in which Dr. Neil Kessel warns against excessive prescribing of narcotic drugs is highlighted. The term “attempted suicide” is discussed in terms of the mindset of the attempter. Survival depends […]

Guns & Gals

Young women are switching from drugs to guns as a way to kill themselves according to this very brief article. In 1970 fewer than one-third of the suicides by women aged 15-24 were with a firearm compared with a little more than half in 1984. In contrast, the percentage of those using drugs dropped from […]

Suicide by Physicians

An examination of the Journal of the American Medical Association obituary notices of male physicians for the years 1966-71 revealed 645 deaths by suicide. Physicians had a higher suicide rate than the general white male population, up to 40% in the 35-70 age group. The physicians used drugs, especially barbiturates, as a method of suicide […]

Head Injury Associated With Barbiturate Suicide

Two cases of self-inflicted injury, associated with suicide by ingestion of barbiturates, are presented. The head injury was so severe in one of the deceased that the death was at first thought to be due to homicide. It is postulated that barbiturate poisoning may induce a phase of excitation, with headache, prior to induction of […]

More and More Barbiturates

This review of barbiturate use in the United Kingdom from 1911 to 1962 revealed the following: suicidal deaths from barbiturate overdose increased from 104 during 1941-50 to 735 during 1958-62, & for accidental deaths from 60 to 285; since 1943 the female suicide rate from barbiturates has exceeded the male; women 45-64 have the highest […]

A Case of Suicide Involving the Concomitant Intravenous Injection of Barbital and Oral Ingestion of Arsenic

The case history of a 51-yr-old male, who committed suicide by orally ingesting arsenic & intrvenously injecting barbital, is discussed. The authors state that this case demonstrates the value of a complete toxicologic evaluation in all such cases, including those in which a single lethal substance has been used & the route of administration is […]

Role of Drugs in Suicide

Dr. Frank Berger reports that barbiturates are most frequently used in suicide attempts (1966). The use of tranquilizers has not decreased the use of barbiturates for suicidal purposes. Four tables list numbers of suicides by specific causes, by type of drug overdose, by analgesic & soporific substances, & by analgesics & soporific substances.

Acute Overdosage of Hypnotic-Sedative-Tranquilizer Drugs with Special Reference to Glutethimide

The general priciples of intensive conservative treatment are reviewed for acute intoxication with drugs having marked central depressed action in overdose, whether or not said drugs are barbituric acid such as hemodialysis are then discussed with special reference to glutethimide intoxication, emphasizing the relationship of therapeutic procedures of this sort to the well-defined patterns of […]

A Study of Poisoning in Delhi

From January 1960 to December 1966, 50 cases of poisoning were admitted to A.I.I.M.S. Hospital, New Delhi. The commonest cause of poisoning in adults was barbiturate ingestion & in children kerosene oil. The male, female ratio was 3:1. The cases of barbiturate poisoning belonged to average middle class families. The cases of kerosene oil poisoning […]

The Epidemiology of Drug Overdosage

An article exploring the use of various types of drugs in addiction & suicide attempts by overdose &/or drugs in combination. (4 pages) (NBB)

Deaths from Poisoning – Massachusetts – 1955 to 1964

The incidence of death from poisonous substances in Massachusetts was reviewed for the 10-year period 1955-64 & compared with 2 earlier 10-year periods–1928-37 & 1938-48, studied with identical methods. Deaths from poisoning, alcohol & illuminating gas declined for the later period while those from carbonmonoxide remained practically unchanged. Only deaths from barbiturates steadily increased during […]

Blood Barbiturate Levels in 175 Suspected Suicide Patients

Severe barbiturate poisoning is likely to occur when 10 or higher multiples of a single hypnotic dose is taken at one time. In this study, blood barbiturate levels were obtained from 175 patients in an unconscious state of drug overdose. 134 had detectable amounts of barbiturate (95 males, 80 females), indicating barbiturates are still fairly […]

Suicide by Poisoning 5: Nursing in the General Ward for the First 24 Hours

The use of peritoneal dialysis to remove barbiturates from the body following a drug overdose is discussed. The nursing care of a 58-year-old female attempter is presented, detailing procedures used from her admission to the point where she regained consciousness & was referred to the psychiatric team. (NBB)

The Immediate Management of Overdose

Success in reviving victims of overdose may be achieved by careful attention to cardiovascular & respiratory support & a high urinary output. In addition to these general principles, special measures may be indicated in cases of specific drug overdose. Such measures are outlined for various drugs, including acetaminophen, aspirin, phencyclidine, barbituates & organophosphates.

Self Poisoning With Drugs: a View From a General Medical Unit