Background
Methods
Study drugs
Deaths
Non-fatal self-poisoning
Prescriptions
Statistical analysis
Ethical approval
Results
Mood Stabilisers
Single-drug deaths in England, total n | Single-drug deaths in England, death rate per 100,000 person-years (95% CI) | Single and first listed drug deaths in England, total n | Single and first listed drug deaths in England, Death rate per 100,000 person-years (95% CI) | Prescriptions, average number per year | Prescription rate per 100,000 person-years (95% CI) | Non-fatal self-poisonings in three centres, average number per year | Self-poisoning rate per 100,000, per 100,000 person-years (95% CI) | |
---|---|---|---|---|---|---|---|---|
Mood Stabilisers | ||||||||
Lithium | 6 | 0.002 (0.001–0.004) | 10 | 0.003 (0.001–0.005) | 4956 | 107.24 (106.18–108.30) | 12 | 1.64 (1.32–2.01) |
Sodium valproate | 15 | 0.004 (0.002–0.007) | 18 | 0.005 (0.003–0.008) | 15,433 | 333.97 (332.11–335.84) | 32 | 4.45 (3.92–5.03) |
Carbamazepine | 33 | 0.010 (0.007–0.014) | 56 | 0.016 (0.012–0.021) | 18,836 | 407.62 (405.56–409.68) | 28 | 3.87 (3.88–4.42) |
Lamotrigine | 5 | 0.001 (0.00–0.003) | 12 | 0.004 (0.002–0.006) | 7635 | 165.22 (163.91–166.54) | 15 | 2.02 (1.67–2.43) |
Total | 59 | 96 | 46,860 | 87 | ||||
Antipsychotics | ||||||||
Chlorpromazine | 12 | 0.004 (0.002–0.006) | 19 | 0.006 (0.003–0.009) | 3760 | 81.37 (80.46–82.30) | 25 | 3.44 (2.97–3.95) |
Risperidone | 1 | 0.000 (0.00–0.002) | 2 | 0.001 (0.00–0.002) | 8302 | 179.65 (178.29–181.03) | 34 | 4.69 (4.15–5.29) |
Quetiapine | 40 | 0.012 (0.008–0.016) | 65 | 0.019 (0.015–0.024) | 9971 | 215.78 (214.28–217.28) | 73 | 10.20 (9.39–11.07) |
Olanzapine | 55 | 0.016 (0.012–0.021) | 78 | 0.023 (0.018–0.029) | 10,568 | 228.70 (227.16–230.25) | 61 | 8.55 (7.81–9.34) |
Clozapine | 35 | 0.010 (0.007–0.014) | 40 | 0.012 (0.008–0.016) | 157 | 3.39 (3.21–3.59) | 4 | 0.54 (0.36–0.77) |
Total | 143 | 204 | 32,758 | 197 |
Case fatality indices
Odds ratio (95% CI) | ||
---|---|---|
Single drug only | Single and first listed drug | |
A. Mood Stabilisers | ||
Lithium | 1.0 | 1.0 |
Sodium Valproate | 0.92 (0.35–2.45) | 0.66 (0.30–1.49) |
Carbamazepine | 2.33 (0.94–5.74) | 2.37 (1.16–4.85) |
Lamotrigine | 0.68 (0.20–2.28) | 0.97 (0.40–2.35) |
B. Antipsychotics | ||
Chlorpromazine | 1.0 | 1.0 |
Risperidone | 0.06 (0.01–0.47) | 0.08 (0.02–0.34) |
Quetiapine | 1.12 (0.58–2.18) | 1.15 (0.67–1.97) |
Olanzapine | 1.84 (0.97–3.52) | 1.65 (0.97–2.80) |
Clozapine | 18.53 (8.69–39.52) | 13.38 (6.88–26.00) |
Fatal toxicity indices
Odds ratio (95% CI) | ||
---|---|---|
Single drug only | Single plus first listed drug | |
A. Mood Stabilisers | ||
Lithium | 1.0 | 1.0 |
Sodium Valproate | 0.80 (0.31–2.07) | 0.58 (0.27–1.25) |
Carbamazepine | 1.45 (0.61–3.45) | 1.47 (0.75–2.89) |
Lamotrigine | 0.54 (0.17–1.77) | 0.78 (0.34–1.80) |
B. Antipsychotics | ||
Chlorpromazine | 1.0 | 1.0 |
Risperidone | 0.04 (0.01–0.29) | 0.05 (0.01–0.21) |
Quetiapine | 1.26 (0.66–2.40) | 1.29 (0.77–2.15) |
Olanzapine | 1.63 (0.87–3.05) | 1.46 (0.89–2.41) |