{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T02:32:28Z","timestamp":1777948348262,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Post\u2010mortem detection of a medicine following suicide can be due to two main reasons: the decedent was taking that medicine therapeutically before death, and\/or the medicine was involved in the suicidal act (poisoning\u2010related suicide). We aimed to investigate how antidepressant concentrations differed between poisoning and non\u2010poisoning suicides. We hypothesized that the predictive value of these concentrations and the separation between poisoning and non\u2010poisoning concentrations would improve by adjusting for dose dispensed to the decedent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed post\u2010mortem toxicology results from suicides in Australia, July 2013 to October 2019, linked to the individual's dispensing history. Suicides were classified as poisoning\u2010 or non\u2010poisoning\u2010related by coroners. We analysed the distribution of concentrations through descriptive statistics, precision\u2010recall curves and quantile regression to compare poisoning and non\u2010poisoning concentrations. We adjusted concentrations by estimated daily dose and total drug quantity dispensed in 90\u2009days and re\u2010assessed model performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We had sufficient sample size to analyse nine antidepressants: amitriptyline (n\u2009=\u2009149), mirtazapine (n\u2009=\u2009399), citalopram (n\u2009=\u2009116), escitalopram (n\u2009=\u2009297), fluoxetine (n\u2009=\u2009183), sertraline (n\u2009=\u2009253), duloxetine (n\u2009=\u2009122), venlafaxine (n\u2009=\u2009261), desvenlafaxine (n\u2009=\u2009194). Selective Serotonin Reuptake Inhibitor non\u2010poisoning and poisoning concentrations were similar, with no high certainty threshold for poisoning for citalopram and sertraline. Amitriptyline had the best separation between poisoning and non\u2010poisoning concentrations. Adjustment by estimated daily dose improved the separation of lower quantiles through quantile regression but did not help identify thresholds that separated poisonings and non\u2010poisonings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dose adjustment generally did not improve the separation of poisoning vs non\u2010poisoning suicides, indicating that post\u2010mortem concentrations may not have clear dose\u2010concentration relationships.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70389","type":"journal-article","created":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T07:46:02Z","timestamp":1765007162000},"page":"1362-1373","source":"Crossref","is-referenced-by-count":0,"title":["Adjustment for dispensed doses does not explain higher antidepressant concentrations in post\u2010mortem toxicology"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3345-782X","authenticated-orcid":false,"given":"Jessy S.","family":"Lim","sequence":"first","affiliation":[{"name":"Biomedical Informatics and Digital Health, Faculty of Medicine and Health The University of Sydney  Australia"},{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Australia"},{"name":"The Matilda Centre for Research in Mental Health and Substance Use The University of Sydney  Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2263-2108","authenticated-orcid":false,"given":"Firouzeh","family":"Noghrehchi","sequence":"additional","affiliation":[{"name":"Biomedical Informatics and Digital Health, Faculty of Medicine and Health The University of Sydney  Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6326-4711","authenticated-orcid":false,"given":"Nicholas A.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Biomedical Informatics and Digital Health, Faculty of Medicine and Health The University of Sydney  Australia"},{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Australia"},{"name":"New South Wales Poisons Information Centre The Children's Hospital at Westmead  Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8870-6272","authenticated-orcid":false,"given":"Jennifer","family":"Schumann","sequence":"additional","affiliation":[{"name":"Victorian Institute of Forensic Medicine  Australia"},{"name":"Department of Forensic Medicine Monash University  Australia"},{"name":"Monash Addiction Research Centre Monash University  Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8946-5079","authenticated-orcid":false,"given":"Rose","family":"Cairns","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Faculty of Medicine and Health The University of Sydney  Australia"},{"name":"New South Wales Poisons Information Centre The Children's Hospital at Westmead  Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2021.3042"},{"key":"e_1_2_10_3_1","volume-title":"Disposition of toxic drugs and chemicals in man","author":"Baselt RC","year":"2008"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/bkae052"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/dta.2655"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2021.110883"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010020\u201002915\u20105"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1520\/JFS14071J"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/31.5.254"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2023.2289"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0118432"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12024\u2010011\u20109278\u2010x"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102020\u2010038181"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51985"},{"key":"e_1_2_10_15_1","unstructured":"Australian Bureau of Statistics.Provisional Mortality Statistics methodology Jan\u2010May 2025. 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