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Practitioner 2010;254 (1733): 7

Which common antidepressants are safest in overdose?

21 Oct 2010Pais-up subscribers

An observational study from the UK has assessed the relative toxicity of 14 antidepressants. As in previous studies, tricyclics were found to be much more toxic in overdose than SSRIs. 'Venlafaxine and mirtazapine were of intermediate toxicity. When choosing an antidepressant, we need to consider not only toxicity in overdose, but also efficacy, acceptability, teratogenicity and the risk of discontinuation reactions. A recent meta-analysis suggested that sertraline provides the most favourable balance between efficacy and acceptability. According to the present study it possesses the further virtue of having a very low toxicity; case fatality ratio 0.4 (95% CI: 0.2-0.8).'

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