[Trends in the pharmaceutical profile of intentional drug overdoses seen in the emergency room].

OBJECTIVES

The aim of the study was to investigate trends in substances used for acute self-administered drug overdoses (SADO).

METHOD: Review of all SADO emergency room visits over two 1-year periods during 1992-1993 (P1) and 2001-2002 (P2).

RESULTS

We compared 804 SADO episodes in P1 with 830 in P2. Patient characteristics did not differ significantly during the two periods (predominance of women: 66 vs 69%; mean age: 33 +/- 12 vs 37 +/- 13.5 years). Psychotropic drugs predominated in both periods (78 and 77%), but the prevalence of benzodiazepines declined (67 to 55%; p < 0.01) and that of antidepressants increased (9.5 to 15%; p < 0.01). Bromazepam was the ben-zodiazepine used most often during both periods (P1: 30% and P2: 35%), but the use of aprazolam increased (from 6 to 17%; p < 0.01). Among the antidepressants, the use of tricyclics decreased (from 43 to 14%; p < 0.01) and that of selective serotonin reuptake inhibitors increased (31 to 71%; p < 0.01). The proportion of benzodiazepine-related drugs increased over time (8.1 to 14%: p < 0.01). The other therapeutic classes remained quite similar to each other between P1 and P2, except for anti-inflammatories (P1: 1.3%, P2: 2.7%; p = 0.01). Among the analgesics, paracetamol alone or combined with other agents predominated (68 and 64% respectively), but use of opiate analgesics was fre-quent during the later period (2.7 vs 22%; p < 0.01).

CONCLUSION

The trend of the different pharmacological families used in SADO seen in the emergency room has not fundamentally changed over the past decade. However, qualitative changes within the drug classes require emergency physicians to update their knowledge of toxicology.