Journal of Affective Disorders 60 (2000) 97–100 www.elsevier.com / locate / jad Research report Deliberate self poisoning with antidepressant drugs: a comparison of the relative hospital costs of cases of overdose of tricyclics with those of selective-serotonin re-uptake inhibitors a, b * Paul Ramchandani (Specialist Registrar) , Brian Murray (Senior House Officer) , c d Keith Hawton (Professor of Psychiatry) , Allan House (Senior Lecturer in Psychiatry) a Child and Family Psychiatric Service, Sue Nicholls Centre, Manor House, Bierton Road, Aylesburg, HP20 1EG, UK b Department of Psychiatry, Oxford University, Oxford, UK c Department of Psychiatry, Oxford University, Oxford, UK d Division of Psychiatry and Behavioural Sciences, University of Leeds, Leeds, UK Received 3 June 1999; received in revised form 5 September 1999; accepted 4 October 1999 Abstract Background: Debate continues over the relative merits of tricyclics and selective serotonin re-uptake inhibitors (SSRIs) as first line antidepressant treatment for depression. SSRIs are safer in overdose but more expensive than tricyclics. This report compared the hospital costs of cases of overdose with both groups of drug. Methods: Records of all persons aged over thirteen years presenting to a general hospital in one year were analysed for demographic information and details of their attendance. Results: There were 1165 episodes of self-poisoning, 151 involving tricyclics as the sole antidepressant and 69 SSRIs as the sole antidepressant. Those taking SSRIs had a shorter (1.96 vs. 2.59 days) and less expensive (£330 vs. £567) stay. A large proportion of this difference in cost was due to a small number of admissions to the Intensive Care Unit. Limitations: This study used only hospital costs, so excluding costs associated with primary care. Conclusions and clinical relevance: If there were similar cost differences countrywide, the difference in hospital costs of self poisoning with SSRIs and tricyclics would represent an additional £3.87 million per year due to self poisoning with tricyclics across the whole of England and Wales. This is a small proportion of the estimated £100 million cost of switching to first-line prescribing of SSRIs for depression.  2000 Elsevier Science B.V. All rights reserved. Keywords: Overdose; Suicide; Antidepressants; Costs 1. Introduction the rates of prescription of selective serotonin re- uptake inhibitors (SSRIs) have increased steadily, Since their widespread introduction in the 1980s, overtaking tricyclic prescribing in 1998 (Mason et al., 1999). However, debate continues over the *Corresponding author. relative merits of SSRIs and tricyclic antidepressants 0165-0327 / 00 / $ – see front matter  2000 Elsevier Science B.V. All rights reserved. PII: S0165-0327(99)00163-9