Multiple Antidepressant Prescriptions Common in Accidental Overdoses

Larry King’s wife, Shawn Southwick King, apparently attempted suicide last week. According to the police report, Southwick left notes regarding where she wished to be buried and was found with empty pill bottles for multiple prescription medications:  Compro, Prometrium, Clonazepam, Ambien, Klonopin, Subutex, Cymbalta and Lyrica.

An examination of this list reveals multiple drugs with overlapping purposes, all of which had sedative, anti-anxiety, or muscle-relaxing properties.

Cymbalta is an anti-depressant, also diagnosed for fibromyalgia; Lyrica is an anticonvulsant also used for fibromyalgia.  In the European Union (but not the U.S.), Lyrica is approved for use to treat generalized anxiety disorder.  Subutex is a narcotic, used to treat narcotic addiction. Clonazepam and Klonopin are the same drug, used to treat panic disorders or seizures. Ambien is a sedative used to treat insomnia.   Compro is an antipsychotic also used to treat anxiety.  Only one of the medications was not in some way a “downer”:  Prometrium is a hormone therapy equivalent to progesterone.

It’s not clear yet whether Southwick King had received prescriptions from multiple doctors, but the redundancy in the list of medications suggests at the very least that she was accumulating a dangerous cocktail of medications, all under “doctor’s orders.”

In this way, her apparent suicide attempt looks a lot like other high-profile overdoses that have been ruled accidental.  Regardless of whether the deaths were suicide or accidental, the over prescription of antidepressant medications makes overdose easier.

Celebrities Michael Jackson, Heath Ledger, and Anna Nicole Smith all died of overdoses of prescribed medications that included antidepressants, sleeping pills, and anti-anxiety medications.

It’s not just celebrities.  A study published last month in the American Journal of Preventive Medicine reported that unintentional deaths by poisoning with prescription sedatives and tranquilizers had increased dramatically over the last ten years.  Between 1996 and 2006, the authors report, hospitalizations for poisoning caused by prescription tranquilizers and sedatives increased by 65%.  Women over 34 were particularly at risk.

While medications have offered help to many, the ease of abuse of these medications presents a problem for the mental health community.  Jeffrey Cohen and his co-authors, who wrote the Preventive Medicine article, suggest that hospitalizations for overdose represent an important opportunity to understand why the overdoses happen.