Review of Changes in Amount of Hospitalizations Related to Poisoning by Chosen Psychotropic Drugs (T43 ICD-10) in Lower Silesia Region of Poland in Years 2006-2012

Abstract: Poisonings by psychotropic drugs in various manners pose a serious public health, forensic and clinical medicine problem especially for the medical staff of toxicology, intensive care and anesthesiology wards. Data on hospital admissions secondary to poisonings by chosen psychotropic drugs (T43 according to ICD-10) in the years 2006-2012, made available due to courtesy of the public healthcare insurance provider Narodowy Fundusz Zdrowia in Lower Silesia region of Poland (NFZ), were analyzed in order to find out the current incidence and trends in the most common and important poisonings to facilitate the process of differential diagnosis for both clinical and forensic medicine purposes. The study revealed that the most commonly reported psychotropic drugs intoxications demanding hospitalization were caused by antidepressants especially tricyclic, tetracyclic and unspecified. The amount of hospital admissions increased in case of poisonings by psychotropic drugs reported without any further active substance specification, as well as due to intoxications caused specifically by: antidepressants other than tricyclic, tetracyclic and monoamine-oxidaseinhibitors; and neuroleptics. There was decrease in hospitalizations due to poisonings by: monoamine-oxidaseinhibitor antidepressants; phenothiazine antipsychotics and neuroleptics; and psychotropic drugs other than antidepressants, antipsychotics, antineuroleptics and psychostimulants. Those findings mirror shifts in medical treatment strategies from classic drugs into their newly developed alternatives and the resultant changes in availability of those drugs to general population. The significant amount of cases reported as poisoning by unspecified psychotropic drug confirms difficulties in establishing proper intoxication diagnosis despite the rapid progress in analytic chemistry techniques in the last decades.