Deliberate Self-Poisoning: Real-Time Characterization of Suicidal Habits and Toxidromes in the Food and Drug Administration Adverse Event Reporting System

Michele Fusaroli (), Guido Pelletti, Valentina Giunchi, Chiara Pugliese, Mattia Bartolucci, Elena Narmine Necibi, Emanuel Raschi, Fabrizio Ponti, Susi Pelotti and Elisabetta Poluzzi
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Michele Fusaroli: University of Bologna
Guido Pelletti: University of Bologna
Valentina Giunchi: University of Bologna
Chiara Pugliese: University of Bologna
Mattia Bartolucci: University of Bologna
Elena Narmine Necibi: University of Bologna
Emanuel Raschi: University of Bologna
Fabrizio Ponti: University of Bologna
Susi Pelotti: University of Bologna
Elisabetta Poluzzi: University of Bologna

Drug Safety, 2023, vol. 46, issue 3, No 5, 283-295

Abstract: Abstract Introduction Deliberate self-poisoning (DSP) using drugs is the preferred method of suicide at a global level. Its investigation is hampered by limited sample sizes and data reliability. We investigate the role of the US FDA Adverse Event Reporting System (FAERS), a consolidated pharmacovigilance database, in outlining DSP habits and toxidromes. Methods We retrieved cases of ‘intentional overdose’ and ‘poisoning deliberate’ from the FAERS (January 2004–December 2021). Using descriptive and disproportionality analyses, we estimated temporal trends, potential risk factors, toxidromes, case-fatality rates and lethal doses (LDs) for the most frequently reported drugs. Results We retrieved 42,103 DSP cases (17% fatal). Most cases were submitted in winter. Reports of DSP involved younger people, psychiatric conditions, and alcohol use, compared with non-DSP, and fatality was higher in men and older patients. Suspected drugs were mainly antidepressants, analgesics, and antipsychotics. Multiple drug intake was recorded in more than 50% of the reports, especially analgesics, psychotropics, and cardiovascular agents. The most frequently reported drugs were paracetamol, promethazine, amlodipine, quetiapine, and metformin. We estimated LD25 for paracetamol (150 g). Conclusion Worldwide coverage of the FAERS complements existing knowledge about DSP and may drive tailored prevention measures to timely address the DSP phenomenon and prevent intentional suicides.

Date: 2023
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DOI: 10.1007/s40264-022-01269-x

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