Acetaminophen Self-Poisoning: Suicidal and Accidental

Objective: Acetaminophen is an over-the-counter drug in Iran. Intentional and accidental poisoning with this drug is one of the most frequent causes of admission to our center. We studied the outcome of poisoning with this drug in our hospital.

Methods: Over a two-year period from January 2005 to January 2007, 85 patients who were admitted to Sina Hospital for acute acetaminophen poisoning, were followed up. Identification and outcome of patients were according to a physical examination, medical history, lab data and duration of hospital stay.

Results: Acute acetaminophen poisoning occurred in both genders and all age groups. Approximately 64 percent of patients were female. Children had minimal involvement and were usually accidental poisoning type (98%). In adults, admissions were more likely to be due to suicide attempts rather than accidental poisoning. The majority of cases were in hepatotoxic dose, but clinical courses were mild. Patients, who had acutely ingested more than 150 mg/kg or predicted to be hepatotoxic due to impaired liver function testes, had a longer hospital stay but in spite of this, we did not have any mortality.

Conclusion: Overdose with acetaminophen in adults was often indications of suicidal behavior, and in children was usually of accidental type. The outcome was generally good in spite of common acetaminophen poisoning.