Suspected suicides and suicide attempts involving antipsychotic or sedative-hypnotic medications reported to America’s Poison Centers, 2000–2021

Abstract

Objective

To investigate the patterns and trends of suspected suicides and suicide attempts involving antipsychotic or sedative-hypnotic medications reported to United States poison centers.

Methods

Data from the National Poison Data System for 2000 through 2021 were retrospectively analyzed.

Results

There were 972,975 suspected suicides and suicide attempts with antipsychotics or sedative-hypnotics ranked as the primary substance reported to poison centers from 2000–2021, averaging 44,226 cases annually. Most (85.6%) cases occurred among individuals >19 years old, females accounted for 63.5% of cases, and 51.8% were single-substance exposures. The rate of reported exposures per 100,000 United States population increased significantly from 27.2 in 2000 to 49.1 in 2008 (P < 0.0001), then plateaued to 49.6 in 2016 (P = 0.1497), followed by a significant decrease to 38.7 in 2021 (P < 0.0001). Individuals 13–19 years old demonstrated the greatest increase in rate from 28.4 in 2000 to 79.6 in 2021 (P < 0.0001). Approximately half (48.8%) of primary substance exposures were benzodiazepines, followed by antipsychotic medications (36.7%) and other types of sedative/hypnotic/anti-anxiety or antipsychotic medications (14.6%). Most primary substance exposures were admitted to a critical care or non-critical care unit (43.3%) or directly to a psychiatric facility (27.9%), and 36.1% were associated with in a serious medical outcome, including 1,330 deaths. Individuals >49 years old were more likely to experience a serious medical outcome (relative risk = 1.25, 95% CI: 1.24–1.26), including death (relative risk = 3.06, 95% CI: 2.74–3.41), or be admitted to a critical care or non-critical care unit (relative risk = 1.24, 95% CI: 1.23–1.24) than younger individuals.

Conclusions

Suspected suicides and suicide attempts involving antipsychotic or sedative-hypnotic medications increased during the 22-year study period, especially among individuals 13–19 years old, and these cases often had severe clinical consequences. Based on the characteristics and trends identified in this study, increased prevention efforts are warranted to help prevent these suspected suicides and suicide attempts.

Keywords:

• Antipsychotics
• sedative-hypnotics
• intentional overdose
• suicide
• intentional self-poisoning

Acknowledgments

America’s Poison Centers maintains the National Poison Data System (NPDS), which houses de-identified records of self-reported information from callers to the country’s poison centers (PCs). NPDS data do not reflect the entire universe of exposures. NPDS data do not reflect the entire universe of exposures to a particular substance as additional exposures may go unreported to PCs; accordingly, NPDS data should not be construed to represent the complete incidence of US exposures to any substance(s). Exposures do not necessarily represent a poisoning or overdose and America’s Poison Centers is not able to completely verify the accuracy of every report. Findings based on NPDS data do not necessarily reflect the opinions of America’s Poison Centers.

Geolocation information

United States

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability Statement

This study utilized data from the National Poison Data System, which is managed by America’s Poison Centers. Data requests should be directed to America’s Poison Centers.

Additional information

Funding

Author, Larissa Ybanez, received a student scholar research stipend from the Child Injury Prevention Alliance while she worked on this study.